Single-site Nissen fundoplication versus laparoscopic Nissen fundoplication

JSLS. 2014 Jul-Sep;18(3):e2014.00202. doi: 10.4293/JSLS.2014.00202.

Abstract

Background: Advances in minimally invasive surgery have led to the emergence of single-incision laparoscopic surgery (SILS). The purpose of this study is to assess the feasibility of SILS Nissen fundoplication and compare its outcomes with traditional laparoscopic Nissen fundoplication.

Methods: This is a retrospective study of 33 patients who underwent Nissen fundoplication between January 2009 and September 2010.

Results: There were 15 SILS and 18 traditional laparoscopic Nissen fundoplication procedures performed. The mean operative time was 129 and 182 minutes in the traditional laparoscopic and single-incision groups, respectively (P=.019). There were no conversions in the traditional laparoscopic group, whereas 6 of the 15 patients in the SILS group required conversion by insertion of 2 to 4 additional ports (P=.0004). At short-term follow-up, recurrence rates were similar between both groups. To date, there have been no reoperations.

Conclusions: SILS Nissen fundoplication is both safe and feasible. Short-term outcomes are comparable with standard laparoscopic Nissen fundoplication. Challenges related to the single-incision Nissen fundoplication include overcoming the lengthy learning curve and decreasing the need for additional trocars.

Keywords: Fundoplication; Gastroesophageal reflux; Laparoscopic surgery; Minimal access surgical procedures; Minimally invasive surgical procedures.

MeSH terms

  • Adult
  • Aged
  • Female
  • Fundoplication / methods*
  • Gastroesophageal Reflux / surgery*
  • Humans
  • Laparoscopy / methods*
  • Male
  • Middle Aged
  • Operative Time
  • Reoperation
  • Retrospective Studies
  • Young Adult