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Laparoscopic Nissen Fundoplication

Marco Fisichella, MD, MBA, FACS1; Ciro Andolfi, MD2
1VA Boston Healthcare System
2University of Chicago Pritzker School of Medicine

1. Introduction

2. Incisions and Port Placements

  1. Insert Veress Needle to Insufflate Abdominal Cavity
  2. Insert Supraumbilical Trocar and Sleeve
  3. Insert Dissecting Port Trocar and Sleeve
  4. Create Incision and Insert Liver Retractor
  5. Insert Babcock Port Trocar and Sleeve
  6. Insert Assisting Port Trocar and Sleeve

3. Mobilization of Esophagus

  1. Cut Gastrohepatic Ligament
  2. Dissect Esophagus from Right and Left Crus
  3. Dissect Fundus of Stomach Towards Splenic Bed
  4. Insert Penrose to Wrap around Esophagus
  5. Dissect Esophagus from Posterior Hiatus
  6. Repair the Hiatus
  7. Perform Shoe Shine Maneuver

4. Fundoplication

  1. Grasp Left and Right Part of Fundoplication
  2. Suture the Fundoplication

5. Closure

  1. Remove Liver Retractor
  2. Remove Trocars and Stitch Ports Shut

6. Post-Operative Interview