Nissen Fundoplication
March 31, 2012
A. Coratti
SUMMARY: As first, a laparoscopic adhesiolysis is performed for a previous laparotomic cholecystectomy to get enough room to dock the robot. After the retraction of the left hepatic lobe, the distal esophagus is isolated, under direct visualization of the vagus nerve.
A Heller myotomy is then performed: an esophago-gastric longitudinal extra-mucosal myotomy is carried up 6 cm on the esophageal side and 2 cm on the gastric side.
An intraoperative endoscopy confirms the dilation of the gastroesophageal junction, excluding the presence of iatrogenic perforation. Eventually, a 180° anti-reflux Dor’s fundoplication is performed as well.
