Nissen Fundoplication

Excerpt

Gastroesophageal reflux disease is a common illness that impacts many people in the modern era. It is recognized worldwide but has been shown to have the highest prevalence in the United States, ranging from 18.1% to 27.8% of individuals. Gastroesophageal reflux disease may present with typical, atypical, and extraesophageal symptoms. Typical symptoms include heartburn and regurgitation; atypical ones include chest pain, dysphagia, abdominal pain, nausea, and bloating; and extra-esophageal symptoms include a cough, hoarseness, pulmonary sequelae, and laryngotracheal stenosis. Treatment for gastroesophageal reflux disease can be medical or surgical. Medical therapy is the first-line treatment. Medical management includes lifestyle modifications and medications such as proton pump inhibitors, H2 antagonists, and sucralfate. Surgical management typically involves laparoscopic anti-reflux surgeries (LARS) and the repair of any existing hiatal hernia. Anti-reflux surgery generally includes a fundoplication, which is a technique to recreate lower esophageal sphincter pressure by wrapping the fundus of the stomach around the esophagus in the abdomen. There are many techniques of LARS, and this article will focus on the popular Nissen fundoplication.