Laparoscopic Nissen Fundoplication Description

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Laparoscopic Nissen Fundoplication Description

OhioHealth Mansfield Laparoscopic Nissen Fundoplication Laparoscopic Nissen Fundoplication is a surgical procedure intended to cure Esophagus gastroesophageal reflux disease (GERD). Reflux disease is a disorder of the lower esophageal sphincter (the circular muscle at the base of the esophagus that serves as a barrier between the esophagus and stomach). When the LES malfunctions, acidic stomach contents are able to inappropriately reflux into the esophagus causing undesirable symptoms. The laparoscopic Nissen Esophageal Fundoplication involves wrapping a small portion of the stomach around the sphincter junction between the esophagus and stomach to augment the function of the Tightened LES. The operation effectively cures GERD with recurrence rates ranging from hiatus 5-10 percent over the life of the patient. Patients who experience a recurrence can be treated medically or undergo a redo laparoscopic Nissen Fundoplication. The most common postoperative side effect of a laparoscopic Nissen Fundoplication is gas bloating. A small percentage of patients (10-20 percent) will not be able to belch or vomit after surgery. Some patients may experience temporary difficult swallowing after surgery. Some patients may experience intermittent episodes of “dumping syndrome” due to Vagus nerve irritation or Top of stomach being excessive acid production in the stomach. wrapped around esophagus Patients are typically on a modified diet for a few weeks after surgery to allow time for healing of the surgical repair and recovery of the function of the esophagus and stomach. Top of stomach fully wrapped around esophagus and sutured Nissen fundoplication © OhioHealth Inc. 2018. All rights reserved. Laparoscopic. 05/18..

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Nissen Fundoplication & Hiatal Hernia Repairs
Post-Operative Instructions Laparoscopic Nissen Fundoplication (or Hiatal Hernia Repair) Description of the Operation We will be doing a laparoscopic Nissen (or Toupet) fundoplication for you. Any hiatal hernia will also be repaired at the time of surgery. A fundoplication involves wrapping a portion of your stomach around your esophagus. This creates a valve-like mechanism to stop reflux of stomach juices into your esophagus (and to prevent a hiatal hernia from recurring). We’ll close your skin with tiny pieces of tape or transparent glue. Be prepared to spend one night in the hospital, although you might not need to, depending on how you feel after surgery. Your Recovery Vigorous straining (or prolonged vomiting) too soon after surgery can damage your diaphragm muscle before the stitches in it have had a chance to heal. This can cause your stomach to move out of position (a hiatal hernia) and the operation to fail or even require re-operation. Almost everybody experiences constant, dull chest, neck or shoulder discomfort when waking up from surgery. It usually fades within a day or two, sometimes longer. Because your operation will be performed laparoscopically, your discomfort will probably resolve before your diaphragm has finished healing. You should avoid heavy-lifting and any activity that causes you to strain and “get red in the face” for at least a month to let the diaphragm heal. You should be able to return to work or usual activities (except for the heavy-lifting) within a few days to a few weeks, depending on the activities. You may resume showering the day after surgery.
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Laparoscopic Antireflux Surgery After Roux-En-Y Gastric Bypass for Obesity
View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Biblioteca Digital da Produção Intelectual da Universidade de São Paulo (BDPI/USP) Universidade de São Paulo Biblioteca Digital da Produção Intelectual - BDPI Sem comunidade Scielo 2012 Modified Nissen fundoplication: laparoscopic antireflux surgery after Roux-en-Y gastric bypass for obesity Clinics,v.67,n.5,p.531-533,2012 http://www.producao.usp.br/handle/BDPI/40389 Downloaded from: Biblioteca Digital da Produção Intelectual - BDPI, Universidade de São Paulo CLINICS 2012;67(5):531-533 DOI:10.6061/clinics/2012(05)23 CASE REPORT Modified Nissen fundoplication: laparoscopic anti- reflux surgery after Roux-en-Y gastric bypass for obesity Nilton T Kawahara,I Clarissa Alster,I Fauze Maluf-Filho,II Wilson Polara,III Guilherme M. Campos,IV Luiz Francisco Poli-de-Figueiredo (in memoriam)I I Faculdade de Medicina da Universidade de Sa˜ o Paulo, (FMUSP), Department of Surgical Technique, Sa˜ o Paulo/SP, Brazil. II Faculdade de Medicina da Universidade de Sa˜ o Paulo, (FMUSP), Department of Gastroenterology, Gastrointestinal Endoscopy Unit, Sa˜ o Paulo/SP, Brazil. III Sı´rio Libaneˆ s Hospital, Department of Oncology Surgery, Sao Paulo/SP, Brazil. IV University of Wisconsin School of Medicine and Public Health, Department of Surgery, Wisconsin/USA. Email: [email protected] Tel.: 55 11 5585 9119 CASE DESCRIPTION (normal ,14.72, 95th percentile). Manometry showed a lower esophageal sphincter pressure (LES) of 9 mmHg (normal A 46-year-old white woman presented to the clinic in range from 14.3 to 34.5 mmHg), and the contraction amplitude September 2009 with intermittent abdominal epigastric pain of the proximal and middle region was greater than 30 mmHg accompanied by nausea, heartburn and frequent crises of (50.6 mmHg).
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Fundoplication in the Management of Hiatal Hernia And
Surgery for Obesity and Related Diseases 11 (2015) e19–e20 Online case report Modification of Belsey (Mark IV) fundoplication in the management of hiatal hernia and gastroesophageal reflux disease after sleeve gastrectomy: a case report Wei-Tao Liang, MDa,b, Ji-Min Wu, MDa,*, Zhong-Gao Wang, MDa,b aCenter for GERD, The Second Artillery General Hospital of Chinese People’s Liberation Army, Beijing, P.R. China bDepartment of Vascular Surgery, Xuanwu Hospital, Capital Medical University, Beijing, P.R. China Received November 7, 2014; accepted November 23, 2014 Keywords: Laparoscopic sleeve gastrectomy; Belsey Mark IV; Gastroesophageal reflux disease; Hiatal hernia Gastroesophageal reflux disease (GERD) is a condition manometry demonstrated a hypotensive lower esophageal seen commonly in the bariatric surgery population. sphincter (LES, pressure, 4.0 mm Hg) with normal relax- Although some operations, such as Roux-en-Y gastric ation and normal peristalsis of the esophageal body. bypass, are known to be associated with a reduced After the patient was referred to our center for GERD, a incidence of reflux postoperatively, the prevalence of modified laparoscopic Belsey (Mark IV) fundoplication GERD after laparoscopic sleeve gastrectomy (LSG) may with hiatal hernia repair was performed. The patient was be increased by 2.1% 34.9% [1]. In addition, it is still endotracheally intubated in the supine position using 5 controversial for the treatment of medication-refractory laparoscopic ports under general anesthesia. After dissect- GERD after LSG. Here, we report the surgical management ing the gastrohepatic ligament with harmonic scalpel, a of a patient, suffering from acid reflux, heartburn, and widow was created behind the lower esophagus.
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General Surgery 101: Nissen Fundoplication
SYNOPSIS The Nissen fundoplication, routinely performed laparoscopically, is a procedure indicated to treat gastroesophageal reflux disease (GERD) and hiatal hernias. In short, the surgeon intends to buttress the lower esophageal sphincter (LES) in order to stop gastric reflux into the esophagus. This will decrease the “heartburn” symptoms that the patient feels and lower the chance of developing dysplasia of the esophageal mucosa. In order to tighten the LES, the gastric fundus is wrapped around the base of the esophagus and sutured GENERAL SURGERY in place. The extra tissue that this maneuver adds to the lower esophagus also prevents the stomach from sliding upward through 101: NISSEN the diaphragm hiatus. INDICATIONS FUNDOPLICATION In patients with type I-IV paraesophageal hiatal hernias, Nissen fundoplication is the first line procedure. In patients with refractory GERD, it is usually done after medical treatment has failed. Kelley Yuan, Class of 2023 Symptoms of refractory GERD can include frequent heartburn, severe esophagitis, esophageal ulceration, recurrent strictures, Tyler Bauer, Class of 2020 and esophageal dysplasia (Barrett’s esophagus). To qualify for this surgery, patients must have at least some preserved motility and a normal length esophagus. If motility is very diminished, partial The first time that medical fundoplication should be considered. students enter the OR can be a jarring experience. Successfully MECHANISM OF RELIEF maintaining sterility is hard enough, Fundus reinforcement of the lower esophageal sphincter has two but remembering relevant patient effects. Stomach wall contraction helps close the sphincter to reduce acid reflux. The additional mass of the gastric wrap reduces history, answering “pimp” questions, the risk of recurrent hiatal hernia by producing a plug less prone to and performing basic suturing skills slipping through the opening of the diaphragm.
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A Combination of Laparoscopic Nissen Fundoplication
https://proscholar.org/jcis/ J Clin Invest Surg. 2019; 4(2): 81-87 ISSN: 2559-5555 doi: 10.25083/2559.5555/4.2/81.87 Copyright © 2019 Received for publication: August 05, 2019 Accepted: September 20, 2019 Research article A combination of laparoscopic Nissen fundoplication and laparoscopic gastric plication for gastric esophageal reflux disease and morbid obesity 1 2 Sukru Salih Toprak , Yucel Gultekin 1Beyhekim Hospital, Department of General Surgery, Konya, Turkey 2Sanliurfa Education and Research Hospital, Department of Surgical Intensive Care, Sanliurfa, Turkey Abstract Introduction. The gastroesophageal reflux disease (GERD) is common in obesity due to the increased intra-abdominal pressure. This study retrospectively analyzed the combination (LNFGP) of laparoscopic gastric plication (LGP) and laparoscopic Nissen fundoplication (LNF) applied to patients with obesity and GERD. Materials and Methods. The study included patients operated on between January 1st, 2013 and January 1st, 2016. The body mass index (BMI) of the patients was evaluated both preoperatively and postoperatively. The preoperative and postoperative degrees of esophagitis were compared using upper gastrointestinal tract (UGI tract) endoscopy. Additionally, postoperative complications and mortality were evaluated. Results. In this study, resistance and morbid obesity were evaluated for the 123 patients who underwent combined LNF and LGP operation (due to the co-existence of GERD) with the medical treatment. A statistically significant decrease was observed in the BMI after one-year follow-up (p <0.001). Compared to the preoperative period, an improvement was observed in the degree of endoscopic esophagitis at 12 months postoperatively (p<0.001). Conclusions. In case of the co-existence of morbid obesity and GERD, combined LNF and LGP operation is a good option for the treatment of obesity as well as for obesity-related comorbidities, such as GERD.
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Review Article FUNDOPLICATION CONVERSION in ROUX
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Annotation Gastrostomy Feeding in The
Arch Dis Child 1999;81:463–464 463 Arch Dis Child: first published as 10.1136/adc.81.6.463 on 1 December 1999. Downloaded from The Journal of the Royal College of Paediatrics and Child Health Annotation Gastrostomy feeding in the disabled child: when is an antireflux procedure required? Children with neurological impairment frequently exhibit endoscopic gastrostomy (PEG) made placement of a clinical evidence of gastrointestinal dysmotility with oral gastrostomy tube possible without laparotomy. Therefore the motor impairment, gastro-oesophageal reflux (GOR), antireflux operation, which previously had been regarded as delayed gastric emptying, and constipation—for example, an adjunct to gastrostomy formation, became a separate numerous reports have shown a high incidence of GOR major abdominal operation with significant morbidity. (15–75%) in neurologically impaired children.1–3 Recent Second, there was evidence from an increasing number of studies using electrogastrography have suggested that centres that gastrostomy tube placement did not consistently vomiting in children with central nervous system disease promote GOR and, therefore, antireflux surgery was not involving the brainstem nuclei or regions next to the area essential in patients who did not have clinical evidence of postrema (the “vomiting centre”) may result from a wide- GOR before gastrostomy. In 1988, Langer et al reported that spread disturbance of gastrointestinal motility (gastric dys- of 50 patients who had gastrostomy alone, 22 (44%) rhythmia) or a persistent activation
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