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Dr. Steven Williams in Boise, Idaho

14Nov

What is Nissen Fundoplication?

Dr. Steve Williams | Gastroesophageal Reflux Disease (GERD) | | View Counts (8023) |Return|

Nissen fundoplication is a common surgical procedure used to treat GERD (gastroesophageal reflux disease) as well as hiatal hernias. It is often a last resort for patients with GERD, used only when other medical treatments have failed. For hiatal hernias, however, it is the most common surgical treatment.

Fundoplication is a surgical technique in which the upper area of the stomach (the gastric fundus) is wrapped, to varying degrees, around the bottom of the esophagus. A Nissen Fundoplication is known as a "complete fundoplication," in which the fundus is completely wrapped around the esophagus. The fundus is then stitched into place, which improves the lower esophageal sphincter's ability to close.

Nissen fundoplication also involves stitching (suturing) a hole in the diaphragm (known as the esophageal hiatus). This step helps treat concurrent instances of hiatal hernia, which occurs when the fundus moves upwards through the diaphragm.

The procedure was first performed in 1955 by Dr. Rudolph Nissen (he referred to it as "gastroplication"), but it didn't become a popular surgical procedure until the 1970s, when it was named for him. The procedure is now performed laparoscopically, meaning that it is only minimally invasive.

Benefits of Nissen Fundoplication for People with GERD

Although Nissen fundoplication is usually a last resort for GERD, long-suffering patients often seek the surgery. Although PPI (proton pump inhibitors) drugs and antacids can reduce or mask the effects of acid reflux, these drugs often have a variety of damaging side effects. When these drugs aren't able to properly treat GERD, gastric contents like acid and bile can create their own medical problems.

Efficacy and Safety

The procedure is typically effective. Studies report that 89.5% of patients who have undergone Nissen fundoplication remain symptom-free after 10 years. It is also generally considered safe, with a mortality rate lower than 1%. Complications can include bloating, difficulty swallowing, and scarring.

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Practicing General Surgery in the Boise area since 2002