Transition from open to laparoscopic nissen fundoplication

ABSTRACT

We reviewed Nissen Fundoplication performed from January 2000 to January 2005, encompassing our transition from open to laparoscopic procedures. Records of 33 consecutive patients were reviewed. From year 2000 to 2005, all patients whom suffering from gastro esophageal reflux disease [GERD] and were in need for surgical interference were classified into two groups. First group operated upon by open fundoplication [n= 20]. Second group operated upon laparoscopically [n=13]. Mean operating time for laparoscopic cases was 143 +/- 20 minutes compared with 90 +/- 20 minutes for open cases [P<0.05]. Intraoperative complication rate was similar in both laparoscopic and open group [15%]. Length of hospitalization was shorter for patients who underwent laparoscopic surgery [2.2 days versus 7.2 for open procedures, P <0.05]. In follow-up, 80% of the laparoscopic group was asymptomatic compared with 70% of the open group. In patients who had the open procedure, 15% had wound complications. None of those treated laparoscopically had any complications at trocar insertion sites. Laparoscopic Nissen Fundoplication nowadys is the preferred approach and becomes the first surgical option in treating patients with GERD. It is effective as open fundoplication, safe, associated with a short hospital stay and early return to normal daily life activity