Laparoscopic Nissen fundoplication - Initial experience

Fifty-two patients underwent laparoscopic Nissen fundoplication. Oesophagogastroscopy, ambulatory 24-hour pH-recording and oesophageal manometry were evaluated both preoperatively and at follow-up. Forty-seven operations were completed laparoscopically, five were converted to laparotomy. There was no mortality, but minor postoperative complications occurred in four patients. The mean hospital stay after a laparoscopic operation was three days and sick leave 14 days. After three months, 94 % of the patients were free of reflux symptoms, oesophagogastroscopy showed normal findings in 95 % of the patients and oesophageal 24-hour pH-values were normal in 95 % of the patients. Dysphagia (28 %) and gas bloating (17 %) were the most frequent postoperative complaints. A total of 94 % of the subjects were satisfied with the result. Our initial experience of laparoscopic Nissen fundoplication shows that the operation is safe and efficient in the treatment of gastro-oesophageal reflux disease.