A Modified Technique to Create a Standardized Floppy Nissen Fundoplication Without a Bougie

Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a
Petrus S S CastelijnsJohannes F Smulders

Abstract

Nissen fundoplication is frequently applied in the surgical treatment of patients with gastroesophageal reflux disease (GERD). When the gastroesophageal junction remains too large or becomes too narrow, persistent GERD or dysphagia may occur. To assure a correct size of the gastroesophageal junction, the fundoplication can be created over a bougie. However, this increases the risk of esophageal perforation. Therefore, we have modified a previously described technique to create a standardized fundoplication without the use of a bougie. In this article, we describe this technique and demonstrate the initial results. We describe a technique to create a standardized Nissen fundoplication. After suture repair of the hiatal hernia, three marking sutures were placed on the gastric fundus, based on an equilateral triangle. The size of this triangle determines the final diameter of the fundoplication. With these measurements, we assure sufficient patency, minimize rotation, and create a more reproducible fundoplication that may reduce postoperative dysphagia. We have operated 15 patients according to this technique. Mean operative time was 69.5 (SD 8.4) minutes, no complications occurred. There was no early dysphagia and the mean length...Continue Reading

References

Apr 1, 1992·American Journal of Surgery·A CuschieriL K Nathanson
Mar 24, 1999·Archives of Surgery·S J SootC W Deveney
Aug 24, 2000·Surgical Endoscopy·P R ReardonJ I Kamelgard
Jun 12, 2004·American Journal of Surgery·Richard E DavisCharles J Filipi
May 25, 2005·Annals of Surgery·C Daniel SmithJohn G Hunter
Oct 8, 2005·Surgical Endoscopy·T P HüttlG Meyer
Oct 19, 2005·Archives of Surgery·Patrick PessauxHenri Mosnier
Jun 24, 2006·Annals of Surgery·Atif IqbalCharles J Filipi
Jul 10, 2007·Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus·P M SafranekT C B Dehn
Mar 14, 2009·The British Journal of Surgery·P J LambD I Watson
Aug 21, 2010·Surgical Endoscopy·Dimitrios StefanidisUNKNOWN SAGES Guidelines Committee
Mar 8, 2011·World Journal of Surgery·David I Watson
Apr 18, 2012·ANZ Journal of Surgery·Shijie MaGuoxin Zhang
Apr 25, 2012·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Edward D Auyang, Carlos A Pellegrini
Nov 7, 2012·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Marco E AllaixMarco G Patti
Nov 8, 2013·Surgical Endoscopy·Jeffrey H Peters

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