[Initial experiences with laparoscopic fundoplication]

Abstract

Over the past decade decreasing numbers of anti-reflux surgical procedures have been performed. The two main reasons are improved pharmacotherapeutics and the complication rate associated with anti-reflux surgery. But in patients who are medically refractory or in those requiring long-term medications the Nissen-Rossetti fundoplication still has its place in the therapy of reflux disease. Laparoscopic procedures have begun to replace many conventional operations and have pushed surgeons to use this technique in antireflux surgery. Since April '92 we planned laparoscopic Nissen-Rossetti fundoplications in 22 patients. 21 operations were carried out laparoscopically (1 conversion). There were no intraoperative complications. 1 patient suffered from 10 weeks dysphagia. Oesophagitis was healed in 19 patients and improved (grade IV to I) in 2 after 12 weeks. Our results demonstrate that laparoscopic fundoplication is a proven alternative to open surgery. In the future the possibility of avoiding costs and risks of lifelong drug therapy will help to establish well indicated laparoscopic fundoplication.