Laparoscopic Fundoplication – How much Wrap is Necessary?–Results of a prospective randomized study in an experimental reflux model

Aims: Laparoscopic treatment of gastro-esophageal reflux disease (GERD) can be defined as todays standard. Several different techniques are applied although their mechanisms of action are not fully understood. Material and Methods: 24 pigs were enclosed. GERD was induced by open cardiomyotomy and verified by ambulatory longterm-pH-monitoring. The animals were randomly allocated to receive either 360°(Nissen), 270° posterior (Toupet) or 180° anterior (Dor) laparoscopic fundoplication 2 days following myotomy. Postoperative function was assessed by pH-monitoring, manometry and „yield pressure“ measurements. We use…