[Laparoscopic anti-reflux surgery].

Abstract

The indication for antireflux surgery despite consequent PPI medication includes: persisting disease with non-acid associated symptoms, such as volume reflux, recurrent hoarseness bronchiopulmonal reflux symptoms, in compliance with PPI, recurrent or persisting esophagitis. Our standard procedure is the short full Nissen wrap. Only in a 70% esophageal pump disturbance we actually apply a partial Toupet wrap. In 412 operations (Nissen 82%, Toupet 18%) during one year we observed 1.9% persisting postoperative dysphagia, 5% reflux relapses and 2% gas bloat syndrome of which 1 patient (0.2%) was re-operated. Significant differences between both procedures regarding the rate of function and complication have not been seen. Quality of life nearly came up to that of non-operated healthy patients and was much better than before surgery. The high acceptance of laparoscopic antireflux surgery in a highly selected collective caused a revival of antireflux surgery by minimal invasive methods.