Gastroözofageal Reflü Hastalığı Tedavisinde Konvansiyonel Aletler ile Tek Kesi Laparoskopik Nissen Fundoplikasyon

Abstract

Objective: Since the early 1990s with the development of minimally invasive techniques, laparoscopic Nissen fundoplication has become the gold standard intervention for the surgical treatment of gastroesophageal reflux disease (GERD), and antireflux surgical treatment of GERD can be performed by the single incision laparoscopic technique. In this study, we aimed to assess the safety and feasibility of single incision laparoscopic Nissen fundoplication (SILNF) with a new liver retraction technique. Material and Methods: Ten patients underwent single incision laparoscopic Nissen fundoplication between October 2011 and March 2012. In all patients, upper gastrointestinal endoscopy was performed. Ambulatory 24-h pH impedance monitoring was performed in all patients. The skin, subcutaneous tissue and fascia were incised with a 20 mm vertical midline incision above the umbilicus, and a SILS-Port TM (Covidien Corp, Mansfield, MA, USA) was placed with conventional laparoscopic hand instruments. Results: The procedure was successfully performed in all ten patients. The mean Johnson-DeMeester score was 29±7.9. The mean operation time was 93±14.1 minutes. The hiatal area was clearly visible with the new liver retraction technique which was applied in this study. None of the patients required conversion to an open procedure. Two patients required the insertion of an additional port. There were no intraoperative or early postoperative complications. Conclusion: SILNF is safe and technically feasible, and it can be performed with conventional laparoscopic instruments.