Laparoscopic fundoplication with double sided posterior gastropexy: a different surgical technique.

BACKGROUND:

Laparoscopic Nissen Fundoplication has become the gold standard surgical procedure for management of gastroesophageal reflux disease. Nissen fundoplication provides an effective barrier against reflux. The aim of this study was to evaluate early postoperative outcomes of a different surgical technique, laparoscopic fundoplication with double sided posterior gastropexy.

METHODS:

Data of 46 patients who underwent laparoscopic fundoplication with double sided posterior gastropexy between February 2010 and December 2011 were collected. Surgically, after Nissen fundoplication was completed, 2-4 sutures were passed through the uppermost parts of the posterior and anterior wall of the gastric wrap and then passed gently 1 cm above the celiac artery from the denser fibers of uppermost part of the arcuate ligament. Demographic data, preoperative and postoperative assesments of sympthomatic and functional outcomes of patients were recorded. Length of hospital stay, operative time, early postoperative complications and complications at 1 year follow up, early recurrence rate were also recorded.

RESULTS:

This technique resulted in good symptomatic and clinical outcomes. Only one patient out of 45 patients was reoperated. The early recurrence rate was 2.2%.

CONCLUSION:

Laparoscopic Nissen fundoplication with double sided posterior gastropexy may prevent paraesophageal herniation. It is a reasonably feasible and effective method in surgical management of GERD.