Laparoscopic Anterior 180° Partial Fundoplication - Indian Perspective

  • Dr. Biswabasu Das Mch, Department of Surgical Gastroenterology, Seven Hills Hospital, Vizag, Andhra Pradesh, India
  • Dr. Sandeep Sahu DNB, Department of Surgical Gastroenterology, Seven Hills Hospital, Vizag, Andhra Pradesh, India
  • Dr. Radhakrishna Y DM, Department of Gastroenterology, Radhakrishna Gastro Center, Vizag, Andhra Pradesh, India
  • Bibhabasu Das B Tech, Department of Mechanical Engineering, IIT, Madras, India
Keywords: Laparoscopic Anterior 180° Partial Fundoplication, Gastroesophageal Reflux Disease (GERD), Dyspepsia


Aim: To evaluate Laparoscopic anterior 180° partial fundoplication for its good long-term relief for symptoms of gastroesophageal reflux disease and association with adverse effects.


Study design: Prospectively evaluated case series.

Settings: Tertiary care centers

Patients: The clinical outcomes were determined for all patients who had undergone a laparoscopic anterior partial fundoplication by us between January 1, 2013 to March 31, 2021.

Interventions: Clinical outcome, complications, and follow-up after laparoscopic anterior 180° partial fundoplication was obtained using a structured questionnaire.

Results and Discussion: 228 procedures were performed. The outcome at 0 to 8 years (mean, 4 years) follow-up was determined for 195 patients. 1 death was linked to the laparoscopic procedure and 2 patients died during follow-up due to unrelated causes. For 186 patients (95%) with clinical outcome data at late follow-up, gastroesophageal reflux symptoms were significantly improved following surgery and were well controlled in 9 patients (4.5%). In a subset of 85 patients with more than 5 years of follow-up, relief of heartburn was found in 59 patients (69%). Incidence and severity of heartburn were reduced after surgery in 22 patients (26%), decreased dyspepsia in 80 patients (94%). Normal belching was preserved in 84 patients (99%) and almost all patients were able to eat normally.

Conclusion: Laparoscopic anterior 180° partial fundoplication is an effective procedure for the surgical treatment of gastroesophageal reflux and is associated with a high rate of patient satisfaction at late follow-up. Compared to Nissen's fundoplication it is as good as control of recurrent reflux as well as reduced adverse effects. The patient goes home in 3-4 days. Hence we recommend it as the procedure of choice for reflux symptoms.


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DeMeester TR, Bonavina L, Albertucci M. Nissen fundoplication for gastroesophageal reflux disease. Evaluation of primary repair in 100 consecutive patients. Ann Surg. 1986 Jul;204(1):9-20. doi: 10.1097/00000658-198607000-00002.

Crookes, P. F., & DeMeester, T. R. (1994). Does Toupet fundoplication out-perform the Nissen procedure as the operation of choice for gastro-esophageal reflux disease?. Diseases of the Esophagus, 7(4), 265-267.

Lafullarde T, Watson DI, Jamieson GG, Myers JC, Game PA, Devitt PG. Laparoscopic Nissen fundoplication: five-year results and beyond. Arch Surg. 2001 Feb;136(2):180-4. doi: 10.1001/archsurg.136.2.180.

Bammer T, Hinder RA, Klaus A, Klingler PJ. Five- to eight-year outcome of the first laparoscopic Nissen fundoplications. J Gastrointest Surg. 2001 Jan-Feb;5(1):42-8. doi: 10.1016/s1091-255x(01)80012-3.

Gotley DC, Smithers BM, Rhodes M, Menzies B, Branicki FJ, Nathanson L. Laparoscopic Nissen fundoplication--200 consecutive cases. Gut. 1996 Apr;38(4):487-91. doi: 10.1136/gut.38.4.487.

Watson DI, Liu JF, Devitt PG, Game PA, Jamieson GG. Outcome of laparoscopic anterior 180-degree partial fundoplication for gastroesophageal reflux disease. J Gastrointest Surg. 2000 Sep-Oct;4(5):486-92. doi: 10.1016/s1091-255x(00)80091-8.

Watson A, Jenkinson LR, Ball CS, Barlow AP, Norris TL. A more physiological alternative to total fundoplication for the surgical correction of resistant gastro-oesophageal reflux. Br J Surg. 1991 Sep;78(9):1088-94. doi: 10.1002/bjs.1800780918.

Hagedorn C, Lönroth H, Rydberg L, Ruth M, Lundell L. Long-term efficacy of total (Nissen-Rossetti) and posterior partial (Toupet) fundoplication: results of a randomized clinical trial. J Gastrointest Surg. 2002 Jul-Aug;6(4):540-5. doi: 10.1016/s1091-255x(02)00037-9.

Ludemann R, Watson DI, Jamieson GG, Game PA, Devitt PG. Five-year follow-up of a randomized clinical trial of laparoscopic total versus anterior 180 degrees fundoplication. Br J Surg. 2005 Feb;92(2):240-3. doi: 10.1002/bjs.4762.

Zornig C, Strate U, Fibbe C, Emmermann A, Layer P. Nissen vs Toupet laparoscopic fundoplication. Surg Endosc. 2002 May;16(5):758-66. doi: 10.1007/s00464-001-9092-8.

Walker SJ, Holt S, Sanderson CJ, Stoddard CJ. Comparison of Nissen total and Lind partial transabdominal fundoplication in the treatment of gastro-oesophageal reflux. Br J Surg. 1992 May;79(5):410-4. doi: 10.1002/bjs.1800790512.

Catarci M, Gentileschi P, Papi C, Carrara A, Marrese R, Gaspari AL, Grassi GB. Evidence-based appraisal of antireflux fundoplication. Ann Surg. 2004 Mar;239(3):325-37. doi: 10.1097/01.sla.0000114225.46280.fe.

Luostarinen M. Nissen fundoplication for reflux esophagitis. Long-term clinical and endoscopic results in 109 of 127 consecutive patients. Ann Surg. 1993 Apr;217(4):329-37. doi: 10.1097/00000658-199304000-00004.

O'Boyle CJ, Watson DI, Jamieson GG, Myers JC, Game PA, Devitt PG. Division of short gastric vessels at laparoscopic nissen fundoplication: a prospective double-blind randomized trial with 5-year follow-up. Ann Surg. 2002 Feb;235(2):165-70. doi: 10.1097/00000658-200202000-00001.

Broeders JA, Broeders EA, Watson DI, Devitt PG, Holloway RH, Jamieson GG. Objective outcomes 14 years after laparoscopic anterior 180-degree partial versus nissen fundoplication: results from a randomized trial. Ann Surg. 2013 Aug;258(2):233-9. doi: 10.1097/SLA.0b013e318278960e.

Du X, Wu JM, Hu ZW, Wang F, Wang ZG, Zhang C, Yan C, Chen MP. Laparoscopic Nissen (total) versus anterior 180° fundoplication for gastro-esophageal reflux disease: A meta-analysis and systematic review. Medicine (Baltimore). 2017 Sep;96(37):e8085. doi: 10.1097/MD.0000000000008085.

Broeders JA, Roks DJ, Ahmed Ali U, Watson DI, Baigrie RJ, Cao Z, Hartmann J, Maddern GJ. Laparoscopic anterior 180-degree versus nissen fundoplication for gastroesophageal reflux disease: systematic review and meta-analysis of randomized clinical trials. Ann Surg. 2013 May;257(5):850-9. doi: 10.1097/SLA.0b013e31828604dd.

NISSEN R. Eine einfache Operation zur Beeinflussung der Refluxoesophagitis [A simple operation for control of reflux esophagitis]. Schweiz Med Wochenschr. 1956 May 18;86(Suppl 20):590-2. German.

Granderath FA, Kamolz T, Schweiger UM, Pasiut M, Haas CF, Wykypiel H, Pointner R. Long-term results of laparoscopic antireflux surgery. Surg Endosc. 2002 May;16(5):753-7. doi: 10.1007/s00464-001-9103-9.

Booth MI, Jones L, Stratford J, Dehn TC. Results of laparoscopic Nissen fundoplication at 2-8 years after surgery. Br J Surg. 2002 Apr;89(4):476-81. doi: 10.1046/j.0007-1323.2002.02074.x.

Watson DI, Jamieson GG. Antireflux surgery in the laparoscopic era. Br J Surg. 1998 Sep;85(9):1173-84. doi: 10.1046/j.1365-2168.1998.00829.x.

Lord RV, Kaminski A, Oberg S, Bowrey DJ, Hagen JA, DeMeester SR, Sillin LF, Peters JH, Crookes PF, DeMeester TR. Absence of gastroesophageal reflux disease in a majority of patients taking acid suppression medications after Nissen fundoplication. J Gastrointest Surg. 2002 Jan-Feb;6(1):3-9; discussion 10. doi: 10.1016/s1091-255x(01)00031-2.

Wijnhoven BP, Lally CJ, Kelly JJ, Myers JC, Watson DI. Use of antireflux medication after antireflux surgery. J Gastrointest Surg. 2008 Mar;12(3):510-7. doi: 10.1007/s11605-007-0443-1.

Rossetti M, Hell K. Fundoplication for the treatment of gastroesophageal reflux in hiatal hernia. World J Surg. 1977 Jul;1(4):439-43. doi: 10.1007/BF01565907.

Ludemann R, Watson DI, Jamieson GG. Influence of follow-up methodology and completeness on apparent clinical outcome of fundoplication. Am J Surg. 2003 Aug;186(2):143-7. doi: 10.1016/s0002-9610(03)00175-2.

DOI: 10.17511/ijoso.2021.i03.01
Published: 2021-06-01
How to Cite
Dr. Biswabasu Das, Dr. Sandeep Sahu, Dr. Radhakrishna Y, & Bibhabasu Das. (2021). Laparoscopic Anterior 180° Partial Fundoplication - Indian Perspective. Surgical Review: International Journal of Surgery, Trauma and Orthopedics, 7(3), 36-43.
Original Article