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  • 7128
  • 2012-03-14

Laparoscopic Nissen fundoplication for atypical symptoms

Epublication WebSurg.com, Mar 2012;12(03). URL:
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Patients with gastro-esophageal reflux sometimes present with conflicting preoperative studies or atypical symptoms. This case had a primary complaint of pain and a normal 24-hour pH study. In this case, there were other indications for surgery - esophagitis and a type I hiatal hernia. Because medications offered no relief, it was elected to proceed with a Nissen fundoplication. A standard 2cm floppy fundoplication and repair of the hiatal hernia was performed in a stepwise fashion: hiatal dissection, esophageal mobilization, gastric fundus mobilization, posterior crural closure, and finally a short 360-degree fundoplication well fixed to the esophagus.