Laparoscopic Nissen fundoplication is a minimally invasive procedure which is done to restore the function of the lower esophageal sphincter (the valve between the esophagus and the stomach) by wrapping the stomach around the esophagus. This procedure creates a new “functional valve” between the esophagus and the stomach and prevents reflux of the acid and bile (non-acidic fluid) from the stomach into the esophagus. It is well studied that patients with typical (common) symptoms of gastroesophageal reflux disease – heartburn, regurgitation and dysphagia (difficulty swallowing) – who respond well to antacid therapy and have a positive esophageal pH assessment (evidence of acid in the esophagus) have the best outcome after laparoscopic Nissen fundoplication.

Laparoscopic Nissen Fundoplication Procedure

The steps of the operation are as follows:

Step 1

Laparoscopic Nissen Fundoplication Procedure
Five small incisions are made in the abdomen where a camera and working surgical instruments are placed.

Step 2

Laparoscopic Nissen Fundoplication Procedure
The esophagus is mobilized and the opening in the diaphragm (crural opening) is identified.

Step 3

Laparoscopic Nissen Fundoplication Procedure
The crural opening is then closed.

Step 4

Laparoscopic Nissen Fundoplication Procedure
The fundus (upper part of the stomach) is then wrapped around the lower portion of the esophagus.

Step 5

Laparoscopic Nissen Fundoplication Procedure
The fundoplication is formed by suturing the stomach around the esophagus.

Laparoscopic Nissen Fundoplication Recovery

Following surgery, patients stay in the hospital for one night. They start drinking one day after surgery and are discharged home. They will follow dietary restrictions for about two weeks and can start advancing their diet after the clinic visit two weeks after surgery.

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