Division of the Short Gastric Vessels During Laparoscopic Nissen Fundoplication does Not Change the Clinical Outcome (A Prospective Study in 26 Egyptian Patients)

Laparoscopic fundoplication, like other laparoscopic procedures, has reduced wound-related morbidity; resulting in shortened hospital stay, diminished postoperative discomfort, and earlier return to normal activities. There are yet controversies about the necessity of division of the short gastric vessels and full mobilization to perform an adequate fundoplication. Twenty Six patients were included in this study, 14 females and 12 males. Their age range was 28 to 56 years (mean 45). Patients were randomized into two groups, undergoing fundoplication with division of the short gastric vessels (Nissen fundoplication, group A) or without division of the short gastric vessels (Rossetti modification, group B). The operating time was 115-175 minutes (mean 140 minutes) in group A compared to 85-135 minutes (mean 107 minutes) for group B. The mean hospital stay was 2.5 days (range 2 to 5 days) for group A and 2.3 days (range 2 to 4) for group B. It was clear that dysphagia and inability to belch were more common in group A, whereas epigastric fullness, discomfort and early satiety were more in group B. However, the difference was not statistically significant, although it is a small group study. Both procedures had overall similar results over one year post operatively. The choice of procedure can therefore be left to the surgeon who will decide according to his preference and his experience which also affects the duration of the procedure.