Laparoscopic Nissen fundoplication is an effective treatment for gastroesophageal reflux disease

Ronald A. Hinder, Charles Filipi, Gerald Wetscher, Patricia Neary, Tom R. DeMeester, Galen Perdikis

Research output: Contribution to journalArticle

526 Citations (Scopus)

Abstract

Objective: The open Nissen fundoplication is effective therapy for gastroesophageal reflux disease. In this study, the outcomes in 198 patients treated with the laparoscopic Nissen fundoplication was evaluated for up to 32 months after surgery to ascertain whether similar positive results could be obtained. Summary Background Data: To ensure surgical success, patients were required to have mechanically defective sphincters on manometry and increased esophageal acid exposure on 24-hour pH monitoring. The patients either had severe complications of gastroesophageal reflux disease or had failed medical therapy. These requirements have been found to be necessary to ensure a successful surgical outcome. Methods: The disease was complicated by ulceration (46), stricture (25) and Barrett's esophagus (33). Patients underwent standard Nissen fundoplications identical in every detail to open procedures except that the procedures were carried out by the laparoscopic route. Results: Perioperative complications included gastric or esophageal perforation (3), pneumothorax (2), bleeding (2), breakdown of crural repair (2) and periesophageal abscess (1). The only mortality occurred from a duodenal perforation. Six patients required conversion to the open procedure. The median hospital stay was 3 days. One hundred patients were observed for follow-up for 6 to 32 months (median 12 months), with outcomes similar to the open Nissen fundoplication. Further surgery was required for two patients who had recurrent gastroesophageal reflux and one who developed an esophageal stricture. Ninety-seven percent are satisfied with their decision to have the operation. Conclusions: The laparoscopic Nissen fundoplication can be carried out safely and effectively with similar positive results to the open procedure and with all of the advantages of the minimally invasive approach.

Original languageEnglish
Pages (from-to)472-483
Number of pages12
JournalAnnals of Surgery
Volume220
Issue number4
StatePublished - Oct 1994

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Fundoplication
Gastroesophageal Reflux
Therapeutics
Esophageal Perforation
Conversion to Open Surgery
Esophageal Stenosis
Barrett Esophagus
Manometry
Pneumothorax
Abscess
Length of Stay
Leg
Stomach
Pathologic Constriction
Hemorrhage
Acids
Mortality

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Hinder, R. A., Filipi, C., Wetscher, G., Neary, P., DeMeester, T. R., & Perdikis, G. (1994). Laparoscopic Nissen fundoplication is an effective treatment for gastroesophageal reflux disease. Annals of Surgery, 220(4), 472-483.

Laparoscopic Nissen fundoplication is an effective treatment for gastroesophageal reflux disease. / Hinder, Ronald A.; Filipi, Charles; Wetscher, Gerald; Neary, Patricia; DeMeester, Tom R.; Perdikis, Galen.

In: Annals of Surgery, Vol. 220, No. 4, 10.1994, p. 472-483.

Research output: Contribution to journalArticle

Hinder, RA, Filipi, C, Wetscher, G, Neary, P, DeMeester, TR & Perdikis, G 1994, 'Laparoscopic Nissen fundoplication is an effective treatment for gastroesophageal reflux disease', Annals of Surgery, vol. 220, no. 4, pp. 472-483.
Hinder RA, Filipi C, Wetscher G, Neary P, DeMeester TR, Perdikis G. Laparoscopic Nissen fundoplication is an effective treatment for gastroesophageal reflux disease. Annals of Surgery. 1994 Oct;220(4):472-483.
Hinder, Ronald A. ; Filipi, Charles ; Wetscher, Gerald ; Neary, Patricia ; DeMeester, Tom R. ; Perdikis, Galen. / Laparoscopic Nissen fundoplication is an effective treatment for gastroesophageal reflux disease. In: Annals of Surgery. 1994 ; Vol. 220, No. 4. pp. 472-483.
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