Laparoscopic Nissen fundoplication - Dr R K Mishra

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Laparoscopic Nissen fundoplication is a surgical procedure that alleviates gastroesophageal reflux disease (GERD) symptoms when lifestyle changes or anti-reflux medications have not controlled symptoms. The procedure was first performed in 1951 as an open-surgical procedure. Patients were hospitalized for 7 to 10 days after the procedure. Today, the Nissen fundoplication is performed in approximately 90 minutes. A majority of the time the patient is in the hospital overnight and is discharged the morning after surgery. Laparoscopic Nissen fundoplication is one of the popular surgery performed by general surgeon. Almost 90% of all the fundoplication in whole world is now performed via laparoscopic surgery. It is a surgical procedure to treat gastroesophageal reflux disease (GERD) and hiatal hernia. In GERD, it is usually performed when medical therapy has failed; but, with a Type II (paraesophageal) hiatus hernia, it is the first-line procedure. The Nissen fundoplication is total (360°), but partial fundoplications known as Thal (270° anterior), Belsey (270° anterior transthoracic), Dor (anterior 180–200°), Lind (300° posterior), and Toupet fundoplications (posterior 270°) are alternative procedures with somewhat different indications and outcomes. In this procedure, the top part of the stomach (approximately 5 percent) is wrapped around the esophagus to form an additional valve to keep stomach contents from flowing up into the esophagus. The patient has five or six incisions, about ¼-inch each, in the abdomen. Post-operation, after arousing from the anesthesia, the patient is given liquids to drink, advancing then to a soft diet. It is a successful treatment in about 95 percent of the patients who have surgery.