What are the risks of fundoplication?
Possible complications associated with laparoscopic Nissen fundoplication include: Bleeding at the surgical site. Difficulty swallowing (dysphagia) because your stomach is wrapped too high on your esophagus or wrapped too tightly. Difficulty belching.
What happens when a fundoplication slips?
If the procedure is performed improperly, however, the fundoplication can slip down onto the body of the stomach, resulting in recurrent reflux and possible obstruction.
What happens when a Nissen fundoplication come undone?
These symptoms commonly include dysphagia, chest pain, and regurgitation. The wrap that has loosened or come undone more commonly presents with recurrent GERD symptoms, often identical to those being experienced before the first antireflux procedure.
What causes fundoplication failure?
The rate of failure following fundoplication varies from 2% to 30%, and revision is required in many of the patients who have recurrent or new foregut symptoms. Common causes of failure include hiatal hernia, wrap disruption, slipped wrap, and misplaced wrap.
How safe is fundoplication surgery?
The surgery is relatively safe with morbidity of less than 1%. Like any major surgery, fundoplication also has a risk for complications that are usually treatable or transient. Some common complications are: Bleeding.
What happens when fundoplication fails?
Conclusions: Failure of fundoplication is unusual in experienced hands. Most are managed within 2 years of the initial operation. Wrap herniation has now become the most common mechanism of failure requiring redo. Redo fundoplication was successful in 93% of patients, and most could be safely handled laparoscopically.
What is the failure rate of Nissen fundoplication?
Failure of open fundoplication occurs in 9% to 30% of patients, depending on how failure is defined and how long until follow-up. Published failure rates of laparoscopic Nissen fundoplication are 2% to 17%, 7–11 depending on the definition of failure and the experience of the surgeons.
Can a failed Nissen fundoplication be redone?
A first-time redo antireflux surgery can be performed by minimally invasive approach. The most common procedure will be a redo laparoscopic Nissen fundoplication. The procedure may need to be done via a laparotomy (an incision in the abdomen) in selected patients.
Can you have fundoplication surgery twice?
In summary, carefully selected patients who have recurrent or persistent problems after fundoplication can safely undergo redo fundoplication with good results. In experienced hands, most patients can be approached laparoscopically.