FUNDOPLICATION (LAPAROSCOPIC) (NISSEN)
Indication: Gastro-oesophageal reflux disease (GORD) refractory to medical therapy, or preference to avoid long-term medication. Also indicated in confirmed GORD with positive pH studies, typical reflux symptoms, and symptomatic response to PPIs.
Patient Position: Supine, reverse Trendelenburg. Arms out.
Anaesthesia: General.
Ports: Five laparoscopic ports.
Procedure:
1. Peritoneal cavity entered. Omentum and stomach inspected.
2. Gastrohepatic ligament divided. Phrenoesophageal ligament divided to mobilise the distal oesophagus.