Laparoscopic Nissen Fundoplication

laparoscopic-nissen-fundoplication-setup-2 laparoscopic-nissen-fundoplication-setup-1

Mayo stand and back table instruments for Laparoscopic Nissen Fundoplication surgery setup

Clamping & Occluding

  • Curved Hemostat

    Curved Hemostat

  • Kocher Forceps

    Kocher Forceps

  • Allis Forceps

    Allis Forceps

Cutting & Dissecting

  • L Hook Cautery

    L Hook Cautery

  • #3 Knife Handle

    #3 Knife Handle

  • Laparoscopic Metz Scissor

    Laparoscopic Metz Scissor

  • Straight Mayo Scissor

    Straight Mayo Scissor

Grasping & Holding

  • Standard Laparoscopic Grasper

    Standard Laparoscopic Grasper

  • Laparoscopic Babcock Forceps

    Laparoscopic Babcock Forceps

  • Laparoscopic Grasping Forceps

    Laparoscopic Grasping Forceps

  • Laparoscopic Allis Grasper

    Laparoscopic Allis Grasper

  • Fundus Laparoscopic Grasping Forceps

    Fundus Laparoscopic Grasping Forceps

  • Adson Forceps

    Adson Forceps

Retracting & Exposing

  • Fan Retractor

    Fan Retractor

  • Hasson S Retractor

    Hasson S Retractor

Suctioning

  • Suction Irrigator

    Suction Irrigator

  • Yankauer Suction

    Yankauer Suction

Suturing & Stapling

  • Appel Laparoscopic Knot Pusher

    Appel Laparoscopic Knot Pusher

  • Mayo-Hegar Needle Holder

    Mayo-Hegar Needle Holder

  • Bariatric and Laparoscopic Needle Holder

    Bariatric and Laparoscopic Needle Holder

What to expect during Laparoscopic Nissen Fundoplication

The patient will be positioned in lithotomy with the head tilted up. The doctor usually stands in between the patient’s legs, whoever is holding the camera will usually be on the right, with the surgical technologist on the left.

Trocar incision sites will be made using the #3 knife handle with an 11 blade loaded onto it. Usually around 5 trocars are used, and the size will depend on the surgeon’s preference. The surgeon will insert some laparoscopic graspers, and look around to see what they are dealing with. A fan retractor will be used to retract the liver.

The esophageal hiatus will be viewed, and a babcock will be placed on the fat pad and be retracted with tension. A cautery hook and a grasper will be used on the ligament, while avoiding the nerves and hepatic artery. This will make a “window”.

They will then do blunt dissection with their graspers around the esophagus. Once all of the major body landmarks have been found and dissected, then the hiatus can be closed, usually with proline suture. A bougie may be placed in the esophagus to make sure they are suturing in the right place. A harmonic may be used on vessels. The stomach will then be freed by ligating the gastric vessels.

Closure can then begin after hemostasis is achieved.

2 thoughts on “Laparoscopic Nissen Fundoplication

    • Diana Lei-aloha says:

      You are welcome! Thank you for the request! Let us know if there’s any other guides you’d like to see!

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