Modified fundoplication technique for correction of gastroesophageal reflux in children.

A modification of the Nissen fundoplication for correcting GER in children is described. This method involves creating a reinforced fundoplication below the diaphragm at the gastroesophageal junction. Two additional lateral rows of sutures are used to reinforce the conventional Nissen fundoplication. This modified technique prevents symptomatic recurrence by lessening the chance of disruption of fundoplication sutures, and it prevents formation of paraesophageal hiatal hernia. We conclude that the modified fundoplication technique is both safe and effective for use in treating children with GER.