Postoperative Swallowing Difficulties and Immediate Outcomes After Laparoscopic Floppy Nissen Fundoplication with V-flap Suturing

Overview

This study evaluates the incidence of postoperative dysphagia and reflux control in patients undergoing laparoscopic floppy Nissen fundoplication with V-flap suturing compared to conventional Nissen fundoplication. Results indicate a significant reduction in dysphagia rates with the modified technique.

Background

Gastroesophageal reflux disease (GERD) is a prevalent condition that can lead to serious complications if untreated. Surgical options, particularly fundoplication, are essential for patients with moderate-to-severe GERD who do not respond adequately to medical therapy. However, postoperative dysphagia remains a significant concern, necessitating innovations in surgical techniques to improve outcomes.

Data Highlights

Key Findings

• The laparoscopic floppy Nissen fundoplication with V-flap suturing significantly reduces postoperative dysphagia compared to conventional Nissen fundoplication.
• Postoperative dysphagia rates in the LNF-V group were reported to be less than 10%.
• Conventional Nissen fundoplication has a dysphagia incidence of approximately 28%.
• Most cases of postoperative dysphagia are transient and resolve within 6 to 8 weeks.
• Persistent dysphagia can occur in 3% to 10% of cases, often related to wrap tightness or motility disorders.

Clinical Implications

Surgeons should consider the laparoscopic floppy Nissen fundoplication with V-flap suturing as a viable option for patients at risk of postoperative dysphagia. This technique may enhance patient outcomes by balancing effective reflux control with a lower incidence of swallowing difficulties.

Conclusion

The laparoscopic floppy Nissen fundoplication with V-flap suturing presents a promising modification that may improve postoperative swallowing outcomes while maintaining effective reflux control. Further studies are warranted to validate these findings.

References

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8. Postoperative dysphagia and short-term outcomes following laparoscopic floppy Nissen fundoplication combined with V-flap suturing - PMC