Laparoscopic Nissen fundoplication in the management of gastroesophageal reflux disease: a single centre experience

Abstract

Background: Laparoscopic Nissen fundoplication is currently the surgical treatment of choice for gastro-esophageal reflux disease (GERD) in properly selected patients.Methods: Laparoscopic Nissen fundoplication was performed in 36 patients of GERD, Government Medical College over a period of 2 years. Pre-operative evaluation included baseline investigations and clinical assessment by using GERD Questionnaire and specific investigations i.e., barium esophagram, esophago-gastroduodenoscopy, esophageal manometry and 24 hour ambulatory pH monitoring of the esophagus. All patients underwent laparoscopic Nissen Fundoplication. Patients were evaluated at three months after surgery with symptom scoring questionnaire.Results: Mean age of patients in our study was 38 years and most common symptoms were heartburn and regurgitation. Four patients (11%) developed complications. The conversion rate to laparotomy was 2.7% (1 patient). Average symptom scores decreased from 10/18 to 0/18 after fundoplication (<0.0001) and all the eight patients who underwent postoperative endoscopy had normal results.Conclusions: Laparoscopic Nissen’s fundoplication is a safe and effective procedure for GERD, having an acceptable hospital stay with consistently improved short term symptomatic and endoscopic results.