Laparoscopic Nissen fundoplication is a minimally invasive procedure which is done to restore the function of the lower esophageal sphincter (the valve between the esophagus and the stomach) by wrapping the stomach around the esophagus.

This procedure creates a new “functional valve” between the esophagus and the stomach and prevents reflux of the acid and bile (non-acidic fluid) from the stomach into the esophagus. It is well studied that patients with typical (common) symptoms of gastroesophageal reflux disease – heartburn, regurgitation and dysphagia (difficulty swallowing) – who respond well to antacid therapy and have a positive esophageal pH assessment (evidence of acid in the esophagus) have the best outcome after laparoscopic Nissen fundoplication.

The steps of the operation are as follows:

Five to six small incisions are made in the abdomen where a camera and working surgical instruments are placed, as shown in the following images.

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The esophagus is mobilized and the opening in the diaphragm (crural opening) is identified.
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The crural opening is then closed.
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The fundus (upper part of the stomach) is then wrapped around the lower portion of the esophagus.
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The fundoplication is formed by suturing the stomach around the esophagus.
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Stomach sutured around esphagus.

Following surgery, patients stay in the hospital for one night. They start drinking the night of the surgery and the diet is advanced the following day prior to discharge. They will follow some dietary restrictions for 4 to 6 weeks and usually no dietary restrictions thereafter.