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MMCTS (December 5, 2008). doi:10.1510/mmcts.2007.002931
Copyright © 2008 European Association for Cardio-thoracic Surgery

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Philippe Nafteux
Willy Coosemans
Paul De Leyn
Dirk Van Raemdonck
Georges Decker
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Right arrow Esophageal disease
 

Procedure


Laparoscopic Nissen fundoplication

Philippe Nafteux*, Willy Coosemans, Paul De Leyn, Dirk Van Raemdonck, Herbert Decaluwé, Georges Decker and Toni Lerut

Department of Thoracic Surgery, UZ Gasthuisberg, Herestraat 49, 3000 Leuven, Belgium

* Corresponding author: Tel.: +3216346822; fax: +3216346821. Philippe.Nafteux{at}uzleuven.be

The dissection is started performing a crural dissection with visualization and preservation of both vagus nerves, followed by circumferential dissection of the esophagus at the gastro-esophageal junction. Adequate intra-mediastinal mobilization of the esophagus is performed to obtain 3–4 cm of intra-abdominal esophagus without undue downward traction on the cardia or stomach. The gastric fundus is then mobilized through adequate short gastric vessel division. The left and right pillars of the right diaphragmatic crus are approximated using interrupted sutures. A short (<2 cm), floppy 360° fundoplication anchored to the esophagus is created.

Key Words: Antireflux procedure • Fundoplication • Gastro-esophageal reflux (GER) • Laparoscopic Nissen

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Copyright © 2008 by The European Association for Cardio-thoracic Surgery.