A Modified Nissen - Toupet Procedure for the Treatment of Gastro-esophageal Reflux Disease and Hiatal Hernia: How I Do It

A MODIFIED NISSEN TOUPET PROCEDURE FOR THE TREATMENT OF GASTROESOPHAGEAL REFLUX DISEASE AND HIATAL HERNIA: HOW I DO IT (Abstract): The laparoscopic fundoplication became the standard treatment for gastro-esophageal reflux disease and hiatal hernia. Nissen and Toupet techniques are the most used surgical procedures. Which of these techniques is superior is a subject of debate. The Nissen procedure appears to be associated with a higher rate of postoperative morbidity (postoperative dysphagia, gas bloat syndrome). It is classically considered the Nissen procedure allows a superior reflux control compared with the Toupet operation. We present our laparoscopic technique which combines the two procedures and which was associated along the time with a low rate of postoperative morbidity and a good reflux control.