Laparoscopic Nissen fundoplication is currently the ‘gold standard for treating GERD in patients who don’t respond completely to medications or can’t take medications for another reason. Laparoscopic Nissen fundoplication is the most commonly performed antireflux procedure. Laparoscopic procedures are performed through very small incisions while the surgeon watches on a video monitor. During surgery, the top of the stomach (the fundus hence the term fundoplication) is wrapped around the bottom of the oesophagus. Another term for the fundoplication is a ‘wrap’. This essentially repairs the valve at the end of the oesophagus that doesn’t work properly in patients with GERD. As opposed to medications for GERD, surgery stops all reflux digestive enzymes AND acid. Because of this, surgery can cure reflux like medications can’t. If a hiatal hernia is present, this is fixed at the same time as the Nissen fundoplication.
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