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Nissen Fundoplication (Laparoscopic)

Surgical procedure for gastroesophageal reflux in which the gastric fundus is wrapped 360 degrees around the esophagus.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Genel Cerrahi department. Book Appointment →

What is Nissen Fundoplication (Laparoscopic)?

Nissen fundoplication is the most commonly performed and gold-standard antireflux operation in the surgical treatment of gastroesophageal reflux disease (GERD). The gastric fundus is wrapped 360 degrees around the lower esophagus, creating a new antireflux barrier.

It is performed laparoscopically through 5 trocars. It includes crural repair, division of short gastric vessels, loose wrapping of the fundus around the esophagus, and creation of a 2-3 cm long loose 'wrap.' The use of a bougie dilator (52-60 F) prevents wrap stricture.

It provides 85-90% long-term improvement in postoperative reflux symptoms. Freedom from long-term PPI use, healing of dilated and damaged esophageal mucosa, and prevention of Barrett's esophagus development are potential benefits. Side effects include dysphagia, gas-bloat, and difficulty swallowing.

Symptoms

GERD symptoms unresponsive to PPI therapy
Atypical reflux: chronic cough, asthma, laryngitis
Esophagitis grade C-D
Development of Barrett's esophagus
Reluctance to remain on long-term medication
Large hiatal hernia (>5 cm)
Regurgitation and aspiration complaints

Risk Factors

Acid exposure time >6% on 24-hour pH monitoring
Normal esophageal peristalsis on manometry
Presence of hiatal hernia
Younger age group (preferring surgery over long-term medication)
Persistent regurgitation despite PPI
Barrett's esophagus and esophagitis complications
Atypical extra-esophageal symptoms

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Persistence of symptoms despite long-term PPI therapy
  • Postprandial regurgitation and aspiration episodes
  • Severe esophagitis or Barrett's on endoscopy
  • Complaints of medication side effects (B12, Mg deficiency)
  • Nocturnal reflux and sleep disturbance
  • If chronic cough and asthma attacks are proven to be reflux-related

Treatment Methods

01
Preoperative endoscopy, 24-hour pH monitoring, and manometry
02
Laparoscopic Nissen fundoplication (360° wrap)
03
Hiatal hernia repair and closure of the crura
04
Creation of a loose wrap over a bougie dilator
05
Mobilization of the fundus by division of short gastric vessels
06
Stepwise transition from liquid to solid diet postoperatively
07
Proton pump inhibitor not required for dyspepsia and gas-bloat

Which Department to Visit?

You can visit our Genel Cerrahi department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.