In a Nissen fundoplication, also called a complete fundoplication, the fundus is wrapped all the way around the esophagus. In a Toupet (posterior) fundoplication, the fundus is wrapped around the back of the esophagus.
Laparoscopic anti-reflux surgery (commonly referred to as Laparoscopic Nissen Fundoplication) involves reinforcing the "valve" between the esophagus and the stomach by wrapping the upper portion of the stomach around the lowest portion of the esophagus - much the way a bun fits around a hot dog.
The primary risk of Nissen fundoplication surgery is that symptom relief does not always last. Some patients need another surgery after two to three years. Like all surgeries, Nissen fundoplication also carries a risk of infection at the incision site.
Nissen fundoplication, also referred to as a Lap Nissen, is a laparoscopic procedure performed for patients with gastroesophageal reflux disease (GERD).
You should be able to progress to a soft-normal diet 4 – 6 weeks after surgery. What is a soft-normal diet? A soft-normal diet involves gradually introducing more solid textures to your diet. While you are having a soft-normal diet you should avoid the same foods you were advised to avoid on page 4.
Side effects of Nissen fundoplication such as dysphagia, increased bloating and flatulence, and inability to belch or vomit may limit the success of antireflux surgery[12,13].
The cramping and bloating usually go away in 2 to 3 months, but you may continue to pass more gas for a long time. Because the surgery makes your stomach a little smaller, you may get full more quickly when you eat. In 2 to 3 months, the stomach adjusts. You will be able to eat your usual amounts of food.
Most patients see an improvement in their symptoms after the procedure and no longer require daily medication. Patients who are elderly, have other health problems, or have weak peristalsis (digestive motion) are not good candidates for a Nissen Fundoplication.
Treating GERD and hiatal hernias with minimally invasive surgery. Nissen fundoplication is a surgical procedure used to treat gastroesophageal reflux disease, or GERD, and hiatal hernia. It tightens and reinforces the sphincter at the top of the stomach to prevent stomach acid from rising into the esophagus.
Laparoscopic Nissen Fundoplication is now considered the gold standard surgical approach for treatment of severe gastroesophageal reflux disease (GERD).
A laparoscopic fundoplication surgery to treat GERD or hiatal hernia is still major surgery and the patient and surgeon should think of it in that light.
I have found that most of my patients have excellent control of their GERD symptoms with a fundoplication wrap that still allows the majority of them to belch and vomit.
Nissen procedure is associated with some weight loss but not enough when compared to gastric sleeve surgery or gastric bypass procedure.
We report an excellent quality of life with a median total score of 70 (range 2–75). Re-operation rate was 13.6% (23/169); the re-operation was due to recurrent reflux in 12 patients and due to persistent dysphagia in 11 patients. 91.3% of the re-operations were performed within the first 5 years after surgery.
This is the name given to the most common operation to stop reflux. The operation helps to prevent vomiting and reflux by “wrapping” the top part of the stomach around the bottom part of the oesophagus. This tightens the oesophagus and prevents backflow of food and stomach acid.
Dumping syndrome is a rare presentation after Nissen fundoplication and is predominantly reported in the pediatric population. Many of these reports suggest that there may be an association with vagal nerve damage, although the exact etiology is unclear.
Nissen fundoplication not only relieves symptoms of acid reflux, but it can also help prevent future complications—even for patients whose acid reflux symptoms are mostly well managed by medications. Oftentimes, these patients are unaware of the long-term effects of GERD.
Postoperative weight gain may lead to fundoplication failure to contain reflux due to the increase in intra-abdominal pressure and modification of the gastroesophageal pressure gradient 14 , 23 . In this case, a new surgery may be necessary to control weight and preserve the anti-reflux mechanism.
Hiatal hernias recur after surgery 15% to 50% of the time, says Miguel Burch, MD, chief of Minimally Invasive and GI Surgery at Cedars-Sinai.
Eating chocolate can result in the GERD symptoms reappearing and kill the purpose of this surgery. Cocoa in chocolate is acidic in nature, and physicians suggest not eating anything that may cause acidity following the Nissen Fundoplication surgery.
Avoid carbonated drinks, alcohol, citrus and tomato products. When will I be able to eat a soft diet? After Nissen fundoplication surgery, your diet will be advanced slowly by your surgeon. Generally, you will be on a clear liquid diet for the first few meals.
Transient dysphagia occurs in 40% to 70% of patients after Nissen fundoplication. This is thought to be secondary to edema at the gastroesophageal junction (GEJ) or transient esophageal hypomotility. Fortunately, dysphagia usually resolves spontaneously within 2 to 3 months.