Nissenfundoplikation

Nissenfundoplikation, commonly known as a Nissen wrap, is a surgical procedure performed to treat severe gastroesophageal reflux disease (GERD). The primary goal of this operation is to strengthen the lower esophageal sphincter (LES), the muscular valve between the esophagus and the stomach, which has become weakened in individuals with GERD. During the procedure, the upper part of the stomach, called the fundus, is wrapped around the lower esophagus. This wrapping creates a tighter seal, preventing stomach acid from flowing back up into the esophagus.

The surgery can be performed using traditional open surgery with a larger incision or, more commonly today, through minimally invasive laparoscopic techniques. Laparoscopic Nissen fundoplikation involves several small incisions through which a laparoscope (a thin, lighted tube with a camera) and specialized surgical instruments are inserted. This approach generally leads to faster recovery times, less pain, and smaller scars compared to open surgery.

Indications for a Nissen fundoplikation typically include patients who have not responded to medical management of GERD, such as medication and lifestyle changes, or those who experience significant side effects from long-term medication use. While effective, the procedure is not without potential risks and complications, which can include difficulty swallowing, gas-bloat syndrome, and the possibility of the condition recurring. A thorough evaluation by a medical professional is necessary to determine if Nissen fundoplikation is the appropriate treatment.