a nissen fundoplication, or laparoscopic nissen fundoplication whilst finished thru laparoscopic surgical operation, is a surgical operation to treat gastroesophageal reflux disorder (gerd) and hiatal hernia. in gerd, it also includes accomplished while medical therapy has failed; however, with a type ii (paraesophageal) hiatus hernia, it's miles the primary-line method. the nissen fundoplication is overall (360°), but partial fundoplications known as thal (270° anterior), belsey (270° anterior transthoracic), dor (anterior a hundred and eighty–two hundred°), lind (300° posterior), and toupet fundoplications (posterior 270°) are alternative approaches with particularly distinctive indicators and results.
at some point of the fundoplication procedure, the part of the belly this is closest to the access of the esophagus (the fundus of the belly) is collected, wrapped, and sutured (sewn) around the decrease stop of the esophagus and the lower esophageal sphincter. (the collection and suturing of one tissue to any other is called plication.) this technique will increase the strain at the lower cease of the esophagus and thereby reduces acid reflux.
also, at some stage in fundoplication, different surgical steps regularly are taken that still may also lessen acid reflux disease. as an instance, if the patient has a hiatal hernia (which occurs in eighty% of sufferers with gerd), the contents of the hernia sac (the belly) may be pulled down from the chest and the opening the diaphragm (the hiatus) through which the esophagus passes from the chest into the abdomen sutured in order that belly stays in the stomach. fundoplication may be carried out the usage of a massive incision (laparotomy within the stomach or thoracotomy inside the chest) or a laparoscope, which requires handiest several small punctures in the stomach. the benefit of the laparoscopic method is a quicker restoration and much less put up-operative ache.