Laparoscopic Nissen fundoplication.

Nissen fundoplication is the procedure of choice for gastroesophageal reflux. In the operating room at St Luke's Episcopal Hospital, Nissen fundoplication has been taken to another level. Because of the increasing trend in laparoscopic surgery and the advanced instruments available, laparoscopic Nissen fundoplication procedures are now performed on a routine basis. One advantage of laparoscopic Nissen fundoplication, as opposed to open Nissen fundoplication, is that the laparoscopic approach is far less invasive. It consists of five 11.5-mm incisions, whereas the open procedure involves a large midline incision. In addition, the overall hospital bill for the laparoscopic procedure can be less than that for an open one; for a laparoscopic Nissen fundoplication, the operating room bill is higher, but the hospital stay is shorter. Usually, the patient can go home the following day and resume daily tasks within days. With an open Nissen fundoplication, the hospital stay is about 3 to 5 days, and because of the large midline incision, a recovery time of 4 to 6 weeks is required. Not only can the patient resume daily activities sooner, but there is generally less pain associated with laparoscopic Nissen fundoplication, and the overall hospital bill is less because of the days spent in the hospital for postoperative recovery.