Laparoscopic Nissen fundoplication: a five-year single-center clinical experience and results.

OBJECTIVE: The current surgical approach in the treatment of hiatal hernia with gastroesophageal reflux disease is known as hernioplasty together with antireflux surgical procedures. Among the antireflux surgical treatment procedures, the most applied approach is the laparoscopic Nissen fundoplication. In this study, we aimed to examine the results and effectiveness of laparoscopic Nissen fundoplication and to share our clinical experiences. PATIENTS AND METHODS: Patients who underwent laparoscopic Nissen fundoplication operation between January 2017 and January 2022 in the general surgery clinic of a tertiary healthcare center were included in the study. The clinical data, preoperative, operative, and postoperative findings and results of the cases were investigated. RESULTS: The mean age of the patients was 46.2 ± 14.7 years, and the female/male ratio was 1.5/1. According to the Clavien-Dindo classification system, 9.9% of the patients had grade I, and 18.3% grade II complications. The patients were followed up for a mean of 32.6 ± 14.8 months. During the follow-up, reoperation was planned in 5.6% of the patients due to recurrence. CONCLUSIONS: Laparoscopic Nissen fundoplication is a well-defined technique. It is a safe and effective surgical method with appropriate patient selection.

MINIMALLY INVASIVE PARATHYROIDECTOMY FOR PRIMARY HYPERPARATHYROIDISM.

CONTEXT: Primary hyperparathyroidism (PHPT), characterized by the inappropriate secretion of parathyroid hormone (PTH) with respect to the extracellular calcium concentration. Curative treatment of PHPT is surgery and bilateral neck exploration has been replaced by minimally invasive parathyroidectomy (MIP), with the advanced imaging technologies combined with radio-guided occult lesion localization (ROLL). OBJECTIVES: The present study analyzes the MIP data from 45 patients who underwent surgery for parathyroid adenoma and debates if MIP is a feasible technique for the treatment of PHPT. DESIGN: The study presents the MIP excision data of 45 hyperparathyroidism patients with a 58-month follow up period. RESULTS: Forty-five operations were performed for 48 parathyroid adenomas. The mean duration of operation was 22.7 (12-55) minutes. Mean follow-up was 14.2 (6-26) months. All patients had normal postoperative calcium levels and PTH levels were normal in the follow-up period, except for one persistent hyperparathyroidism. CONCLUSIONS: ROLL-guided MIP is a feasible technique for parathyroid surgery and reduces surgeon based failure. It also provides the widespread application of parathyroid surgery by decreasing the need for specific experience.