Laparoscopic Nissen fundoplication: technique and preliminary results.
Between May 1991 and November 1992, 80 consecutive patients with gastro-oesophageal reflux disease underwent laparoscopic Nissen fundoplication. The technique used was exactly the same as for the conventional open approach. There were no deaths but there were four peroperative complications: one gastric perforation, two pleural perforations and one hepatic laceration. Three conversions to laparotomy were necessary, one because of a defective needle holder and two as a result of left hepatic lobe hypertrophy. The duration of operation ranged from 40 to 300 (median 150) min. The median postoperative stay was 3 days, but increased to 10 days in two patients who developed pulmonary infection. One major postoperative complication (necrosis of the wrap) required a laparotomy on day 8 after operation. No recurrence of heartburn has been observed and there were no instances of long-term dysphagia after surgery. These findings indicate that laparoscopic Nissen fundoplication can be performed safely if the team is well trained.
Cadière
G B
GB
Department of Surgery, Saint-Pierre Hospital, Brussels, Belgium.
Houben
J J
JJ
Bruyns
J
J
Himpens
J
J
Panzer
J M
JM
Gelin
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005748:Gastric Fundus / Q000601:surgery; D005764:Gastroesophageal Reflux / Q000601:surgery*; D006801:Humans; D007431:Intraoperative Complications / Q000628:therapy; D010535:Laparoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D013997:Time Factors; D016896:Treatment Outcome