Nissen Fundopliation Surgery

Nissen fundoplication is a surgical procedure that is used to treat hiatus hernia, and sometimes to treat GERD (gastroesophageal reflux disease) if medical therapy is not effective. The procedure was developed by Dr. Rudolph Nissen who first performed it in 1955, and the procedure became popular in the 1970s. You may find this overview of Nissen fundoplication surgery helpful.

The procedure

During this surgery, the upper part of the stomach known as the gastric fundus is wrapped around the lower part of the esophagus and stitched into place. This reinforces the closing function of the lower esophageal sphincter and keeps stomach acids from squeezing up into the esophagus, thereby treating GERD. If the GERD patient is also suffering from delayed gastric emptying, the pylorus is sometimes modified through a pyloromyotomy or pyloroplasty. If the problem is a hiatus hernia, the esophageal hiatus is also sutured and narrowed so that the fundus can no longer slide up through the hiatus.

Possible complications

While this procedure is normally safe and effective, patients may experience complications after the surgery. While these complications are sometimes short-term, it is important to report any complications to the doctor. Some of the complications are "gas bloat syndrome", trouble swallowing, dumping syndrome, irritable bowel syndrome, excessive scarring and in rare cases, achalasia.

Generally, Nissen fundoplications are performed laparoscopically now. Around 89.5 percent of patients are symptom-free 10 years after the procedure, although in 5 to 10 percent of cases, the surgery comes undone. This can lead to a resurgence of symptoms and possibly another procedure. Many patients report continual problems vomiting once they undergo fundoplication as well.