Principle of the operation
The aim of the operation is to recreate an anti-reflux valve or fundoplicature. Normaly, the procedure takes place by laparoscopy (Camera using small incisions).
The procedure takes place in two stages:
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bring the lower oesophagus back into the abdomen and treat a possible hiatal hernia by bringing the pillars of the diaphragm closer together,
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wrap the lower oesophagus with the top of the stomach.
There are 3 different fundoplicatures:
Nissen Fundoplication
The most common procedureTotal posterior fundoplicature
Toupet operation
Possible depending on pre-operative testsPartial PosteriorFundoplication
Dor operation
Rarely usedAnterior Fundoplication
Surgical complications:
There are the usual risk associated with any surgery: phlebitis, pulmonary embolism, hemorrhage and infection. During the procedure, it may be necessary to convert, from laparoscopy to open surgery, to control a hemorrhage for example.
Complications of hiatal hernia surgery include:
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Spleen injury: Exceptional but the risk is real due to its proximity to the stomach.
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Dysphagia: difficulty swallowing: this disorder should regress in the following months. If it persists, the fundoplication may be too tight. It can be corrected but requires a second surgery.