Video Tip: Nissen Fundoplication | October 2021-Nissen Fundiplication

Video Transcription

The granddaddy of them all on the anatomic side is the Nissen fundoplication named for Rudolf Nissen.  It's a 360 degree wrap of the fundus around the esophagogastric junction to bolster the lower esophageal sphincter. Mostly it's performed laparoscopically.  And the data actually, there's lots and lots of studies out there, but the data looks really good. If you ask patients 10 years out, would you have the Nissen again?  90% or so of them would say, yeah, I would do it again. Okay. And that was done, those studies were done at a time where we didn't have ready access  to manometry, where we probably exacerbated some of the symptoms like gas bloat and particularly  dysphagia, by doing 360 degree wraps in patients who had underlying significant esophageal dysmotility, where they might not be able to overcome the pressure generated by the  Nissen with a weak swallow.

Video Summary

In this video, the speaker discusses the Nissen fundoplication, an anatomical procedure named after Rudolf Nissen. It involves wrapping the fundus around the esophagogastric junction to strengthen the lower esophageal sphincter. The procedure is mostly performed laparoscopically and has shown positive results in various studies. Despite some potential side effects such as gas bloat and dysphagia, patients generally have a high satisfaction rate, with around 90% of them stating that they would undergo the Nissen fundoplication again. These studies were conducted before manometry was easily available, which might have exacerbated symptoms in patients with underlying esophageal dysmotility.

Keywords

Nissen fundoplication

anatomical procedure

Rudolf Nissen

laparoscopic procedure

lower esophageal sphincter