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WJOLS
WJOLS

10.5005/jp-journals-10033-1243
Laparoscopic Nissen-Rossetti Fundoplication: Possibility Toward Day Care Antireflux Surgeries
reSearch articLe

Laparoscopic Nissen-Rossetti Fundoplication: Possibility

toward Day Care Antireflux Surgeries

Kaundinya Kiran Bharatam

ABSTRACT pH measurement and esophageal manometry have also
As we proceed towards more and more day care surgeries, we been supplemented by the Hill’s grading system of GERD
5
always need to choose patients and procedures within a great based on endoscopy to assess the severity of the disease.
deal of safety margin. Antireflux surgeries are gaining more Many studies have suggested that laparoscopic fundopli-
popularity and awareness and laparoscopic Nissen-Rossetti
fundoplication is a safe and effective method of performing cation is the most effective treatment in the long-term
them. Our case series of 25 patients who underwent day care management of GERD. 6
laparoscopic Nissen-Rossetti fundoplication done over a period Laparoscopic Nissen-Rossetti fundoplication involves
of 3 years suggests the feasibility and safety of performing performing the fundic wrap after ensuring an adequate
day care antireflux surgeries with no complications. Surgical
outcomes of procedure are unaffected and the main chal- length of intra-abdominal esophagus, approximation of
lenge faced remains pain relief and which can be effectively the crural hiatus and accentuation of the angle of His.
tackled by local blocks or plain nonsteroidal anti-inflammatory This differs from the usual Nissen fundoplication by
drugs (NSAIDs). We encourage more studies in this regard
with appropriate blinding to enforce its possibility as day care not having to divide the short gastric vessels along the
surgery and help patients with early recovery and decreasing gastrosplenic ligament. Thus, the procedure has an added
cost of surgeries. advantage of decreasing operating time and minimizing
Keywords: Day care surgery, Gastroesophageal reflux disease, intraoperative and postoperative blood loss. 7
laparoscopic Nissen-Rossetti fundopli cation, transversus abdo - In the present article, we present 25 cases of GERD
minis plane block. who underwent the laparoscopic Nissen-Rossetti fund o-
How to cite this article: Bharatam KK. laparoscopic Nissen- plication at our center during a period of around 3 years
Rossetti Fundoplication: Possibility toward Day Care Antireflux from 2012 to 2015 as a day care procedure (< 24 hours stay).
Surgeries. World J Lap Surg 2015;8(2):35-38.
We would like to highlight the possibility of day care
Source of support: Nil antireflux surgery using laparoscopic Nissen-Rossetti
Conflict of interest: None fundoplication.

MATERiALS AnD METHoDS
inTRoduCTioN
For the period in observation, the following cases were
Antireflux problems and gastroesophageal reflux disease
(GERD) have become common in the present day practice. selected for the day care fundoplication:
The complications associated with GERD like stricture • Patients with GERD symptoms of more than 6 months
esophagus, adenocarcinoma of the esophagogastric duration
junction (OGJ), pulmonary complications, etc. have • Treatment given with PPIs for more than a month and
patients being unresponsive to treatment
prompted clinicians to adopt both medical and surgical • Gastroesophageal reflux disease classification grade
1-4
options to treat this condition. Proton pump inhibitors
(PPIs) have been the mainstay of treatment in this condi- 3 to 4 based on Hill’s system of classification of GERD
using endoscopy
tion and their usage can be up to 6 months continuously.
• Patients with American Society of Anesthesiologists
(ASA) 1 to 2 fitness for surgery
• Patients consenting for the surgery as the choice of
Assistant Professor, Consultant General and Surgeon
treatment for GERD.
Department of General Surgery, Sri Ramachandra Medical Following patients were not selected for the day care
College and Hospital; Department of Laparoscopy and
Endoscopy, Mehta Hospitals, Chennai, Tamil Nadu, India procedure and underwent further evaluation or alter-
native treatment protocol:
Corresponding Author: Kaundinya Kiran Bharatam, Assistant
Professor, Consultant General and Surgeon, Department • Patients unwilling for surgery as the choice of treat-
of General Surgery, Sri Ramachandra Medical College ment for GERD
and Hospital; Department of Laparoscopy and Endoscopy • Gastroesophageal reflux disease classification grade 1
Mehta Hospitals, Chennai, Tamil Nadu, India, e-mail: to 2 based on Hill’s system of classification of GERD
kaundinyakiran@gmail.com
using endoscopy
World Journal of Laparoscopic Surgery, May-August 2015;8(2):35-38 35