Laparoscopic Nissen fundoplication.

Open Nissen fundoplication has been established as an effective treatment in the management of gastroesophageal reflux disease (GORD). Progress in minimally invasive surgery has given the chance of performing laparoscopic Nissen fundoplication. The short-term results are encouraging and its outcome promising. The need for long-term medication ceases and it has already widely replaced the open procedure. Furthermore, the laparoscopic procedure can achieve the repair of any hiatal defect present. Thorough preoperative evaluation is imperative, because it determines the indication for surgery as well as the sort of operation. The laparoscopic procedure ensures a meticulous dissection and full mobilization of the lower oesophagus. These preconditions are of great importance in performing safely a floppy wrap. The method could be followed by complications or failure. Appropriately designed modern equipment is necessary. Thus, much experience and adequate training are required for the perfect application of laparoscopic Nissen fundoplication.