Nissen Fundoplication
Numerous variations are possible depending on the degree of fundal wrapping around the lower end of the oesophagus. In addition the wrap can be classified as loose or tight by an experienced operator.
After mobilising the intra thoracic oesophagus is delivered into the abdomen and encircled with a tape.
After the short and posterior gastric vessels have been divided the fundus is passed behind the oesophagus
Heavy non absorbable sutures passing via the oesphageal wall approximate the seromuscular layers of the fundus anteriorly.
Completed fundoplication with reinforcing oesophageal sutures. The vagi are carefully preserved.
