What is a fundoplication wrap?

During fundoplication surgery, the upper curve of the stomach (the fundus) is wrapped around the esophagus and sewn into place so that the lower portion of the esophagus passes through a small tunnel of stomach muscle.

What is a partial wrap fundoplication?

Partial fundoplication was defined as any surgical technique employing a wrap of less than 360 degrees to correct reflux disease. Complete fundoplication, commonly known as a Nissen fundoplication, was defined by a wrap of at least 360 degrees.

What is the wrap for a hiatal hernia surgery?

Nissen 360-degree wrap. The fundus is wrapped all the way around the bottom of your esophagus to tighten the sphincter. This prevents you from any burping or vomiting that may make your GERD worse.

What happens when a Nissen wrap comes undone?

Complications include “gas bloat syndrome”, dysphagia (trouble swallowing), dumping syndrome, excessive scarring, vagus nerve injury and, rarely, achalasia. The fundoplication can also come undone over time in about 5–10% of cases, leading to recurrence of symptoms.

How painful is Nissen fundoplication?

Laparoscopic Nissen fundoplication is a minimally invasive procedure performed through tiny incisions. Consequently, recovery is fast, and it is associated with very little discomfort.

What are the side effects of fundoplication?

Mechanical side effects of total fundoplication may lead to a functional obstruction in the gastroesophageal junction and to an inability to vent air from the stomach[12]. As a result, we observed common postoperative side effects including inability to belch, abdominal bloating, and increased flatulence.

Can you still vomit after fundoplication?

Just as other body parts, the fundoplication wrap created during the GERD surgery will slowly loosen over time. Therefore even some patients that originally could not burp or vomit will be able to do so as the wrap loosens.

Can I drink coffee after Nissen fundoplication?

Take small bites, chew your food well, and avoid gulping. This helps prevent gas build-up and aids in swallowing. To prevent swallowing air, which produces excess gas, avoid drinking through a straw and don’t chew gum or tobacco. Also avoid caffeine, carbonated drinks, alcohol, citrus, and tomato products.

What is dumping syndrome after Nissen fundoplication?

Dumping syndrome may occur when a large volume of gastric content is delivered to the duodenum or jejunum, resulting in both gastrointestinal and vasomotor symptoms. Occasionally, dumping syndrome may be a complication in patients that have undergone nissen Fundoplication, especially in adults.

Why do Nissen Fundoplications fail?

A slipped Nissen fundoplication may be the result of a technical error in which the fundoplication is incorrectly placed over the stomach or may be due to slippage of the stomach up through an intact wrap. A tight wrap occurs because of poor surgical technique or the misdiagnosis of achalasia.

When does Nissen fundoplication fail?

This is superior to any currently available medical treatment option [1,2]. Failure of Nissen fundoplication occurs when the patient, after the repair, experiences persistent or recurrent reflux symptoms, is unable to swallow normally, or suffers from upper abdominal discomfort or other gastrointestinal symptoms.

Is your stomach smaller after Nissen fundoplication?

The cramping and bloating usually go away in 2 to 3 months, but you may continue to pass more gas for a long time. Because the surgery makes your stomach a little smaller, you may get full more quickly when you eat. In 2 to 3 months, the stomach adjusts. You will be able to eat your usual amounts of food.

How is the fundus wrapped in a Nissen fundoplication?

The surgeon should begin with ligating and dividing the short gastric arteries. In a Nissen fundoplication, also called a complete fundoplication, the fundus is wrapped the entire 360 degrees around the esophagus.

What are the different types of fundoplication wraps?

There are three types of fundoplication: A Nissen 360 degree wrap, A Toupet 270 degree posterior Wrap and A Watson 180 degree anterior wrap. Your surgeon will discuss the individual merits of each with you.

Are there any intrathoracic migrations after Nissen fundoplication?

CONCLUSION. Intrathoracic migration is an important complication of laparoscopic Nissen fundoplication. Most migrations are small and asymptomatic. We propose a simple and reproducible radiologic definition of two different types of intrathoracic migration of the wrap observed after laparoscopic Nissen fundoplication.

Can a gastric fundus prevent a 360 degree wrap?

In rare situations, a small gastric fundus can sometimes prevent us from performing a floppy 360 degree wrap and in this case, a partial 270 degree wrap is indicated. By the same token, patients with a large gastric fundus don’t do well with a partial wrap.