Fundoplication

<Surgery>

<Index>

 

 

 

Rationale

-  First line Mx of hiatus hernia

-  When conservative Mx of GORD has failed

-  Mx of achalasia (partial)

-  +/- Mx of obesity

 

Procedure

-  Laparscopic procedure

-  Gastric fundus is wrapped (plicated) around the inferior oesophagus & stitched

-  Reinforces lower oesophageal sphincter

-  Nissen Fundoplication (Complete)

-  Fundus wrapped completely around lower oseophagus

-  Dor Partial Fundoplication (Anterior)

-  Fundus wrapped around anterior oesophagus

-  Toupet Partial Fundoplication (Posterior)

-  Fundus wrapped around posterior oesophagus

 

Fundoplication

 

Complications

-  < 1% mortality

-  Gas bloat syndrome: unable to belch

-  Dumping syndrome

-  Dysphagia, Achalasia

-  Excessive scarring