Laparoscopic Nissen Procedure

What is the laparoscopic Nissen procedure?

Laparoscopic Nissen surgery is a minimally invasive procedure to treat gastro-oesophageal reflux disease (GERD) by creating a sphincter, a tightening muscle, at the lower part of the oesophagus. GERD occurs when the stomach’s particles travel up the oesophagus, causing heartburn, wheezing, a sore throat, stomach pain and difficulty swallowing.

When is surgery needed?

Laparoscopic Nissen surgery is needed when acid reflux symptoms are continuous, and lifestyle changes and medication fail to provide relief. Exposure to stomach acid causes oesophagitis, a condition that occurs when the oesophageal lining becomes inflamed, leading to ulceration and bleeding. Strictures may develop because the acid from food can irritate the oesophageal lining, causing scar tissue to develop and making it difficult to swallow food.

Barrett’s oesophagus is a serious condition that arises from the occurrence of stomach acid in the oesophagus for a long period of time. As a result, the oesophageal cells and tissues forming the lining can significantly alter. When this happens, the cells can change, potentially leading to the development of cancer.

How is surgery done?

About four to five tiny incisions are made over the abdomen, after which a laparoscope (an instrument with a camera attached) is placed through the incisions. Then, using small surgical tools and pictures the camera produces, Dr Ross is able to manipulate the upper portion of the stomach, wrapping it around the bottom part of the oesophagus. Finally, he uses stitches to seal the incisions.

What can I expect after surgery?

You can expect a sore throat after surgery, which may continue over the next few days.

It is common for patients to experience difficulty swallow immediately after the operation, and this gradually improves over time after the operation. Most patients are able to eat normally after 4-6 weeks.

A team of dieticians are involved from very early on post operatively to guide you through the process of recovery.


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Better is possible. It does not take genius. It takes diligence.
It takes moral clarity. It takes ingenuity. And above all, it takes
a willingness to try.

Atul Gawande, Better: A Surgeon's Notes on Performance


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