Postoperative Swallowing Difficulties and Immediate Outcomes After Laparoscopic Floppy Nissen Fundoplication with V-flap Suturing
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By
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Haijun Du
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Hongyi Dong
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Ying Gao
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Chuntao Liu
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Xing Du
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Diangang Liu
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November 21, 2025
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Clinical Scorecard: Postoperative Swallowing Difficulties and Immediate Outcomes After Laparoscopic Floppy Nissen Fundoplication with V-flap Suturing
At a Glance
| Category | Detail |
|---|
| Condition | Gastroesophageal reflux disease (GERD) |
| Key Mechanisms | Lower esophageal sphincter hypotension, hiatal hernia, impaired esophageal clearance, delayed gastric emptying. |
| Target Population | Patients with moderate-to-severe GERD, especially long-term PPI users with suboptimal symptom control. |
| Care Setting | Surgical intervention in a hospital setting. |
Key Highlights
- Laparoscopic Nissen fundoplication is the gold standard for GERD treatment.
- Postoperative dysphagia occurs in 10% to 25% of patients after Nissen fundoplication.
- Floppy Nissen fundoplication with V-flap suturing significantly reduces dysphagia incidence.
- Most postoperative dysphagia is transient, resolving within 6 to 8 weeks.
- Partial fundoplication techniques may lower dysphagia risk without compromising reflux control.
Guideline-Based Recommendations
Diagnosis
- Objective evidence of GERD with inadequate response to medical therapy.
- Established diagnosis of GERD and unwillingness to continue long-term PPI therapy.
Management
- Lifestyle modifications including small frequent meals and soft diets.
- Endoscopic dilation for severe or persistent symptoms.
Monitoring & Follow-up
- Saeed dysphagia score and Gerd-Q score assessments at 1, 3, 6, and 12 months postoperatively.
Risks
- Persistent dysphagia in 3% to 10% of cases due to tight wraps or motility dysfunction.
Patient & Prescribing Data
173 patients undergoing laparoscopic fundoplication.
LNF-V technique optimizes tension distribution, reducing postoperative dysphagia.
Clinical Best Practices
- Consider modified fundoplication techniques to balance reflux control and dysphagia risk.
- Monitor patients closely for dysphagia and other postoperative complications.
References
