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  • 1. Introduction
  • 2. Access and Placement of Ports
  • 3. Mobilization of Esophagus
  • 4. Fundoplication
  • 5. Closure
  • 6. Post-op Remarks
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Laparoscopic Nissen Fundoplication

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Ciro Andolfi, MD1; Marco Fisichella, MD, MBA, FACS2
1University of Chicago Pritzker School of Medicine
2VA Boston Healthcare System

Procedure Outline

  1. Insert Veress Needle to Insufflate Abdominal Cavity
  2. Insert Supraumbilical Trocar and Sleeve
  3. Insert Dissecting Port Trocar and Sleeve
  4. Insert Liver Retractor
  5. Insert Babcock Port Trocar and Sleeve
  6. Insert Assisting Port Trocar and Sleeve
  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 Shoeshine Maneuver
  1. Grasp Left and Right Parts of Fundoplication
  2. Suture the Fundoplication
  1. Remove Liver Retractor
  2. Remove Trocars and Close Port Sites