TITLE:
Laparoscopic Nissen Fundoplication in the Treatment of Esophageal Diseases: A Retrospective Study of 708 Cases
AUTHORS:
Guilherme Bitencourt Batista, Alice Nunes Bastos, Laura Farage Deud Brum, Pedro Henrique Alvarez Gentil, Augusto Tinoco
KEYWORDS:
Fundoplication, Gastroesophageal Reflux Disease, Esophagitis
JOURNAL NAME:
Surgical Science,
Vol.17 No.2,
February
13,
2026
ABSTRACT: Background: A case of gastroesophageal reflux is a more common esophageal disease, with 20% of adults in the population. Surgery is formally indicated for patients who do not respond to therapy with proton pump inhibitors (PPIs) and patients with erosive disease on long-term use of PPIs. The laparoscopic Nissen fundoplication presents the best results of the open technique seen since there are fewer incidences of postoperative complications. Objective: To share a service experience on laparoscopic treatment of GERD through Nissen’s fundoplication. Method: Retrospective observational study spanning 31 years, based on the medical records of 708 patients who underwent Nissen fundoplication in the general surgery department were applied. Stratified according to sex, age, main surgical indication, intraoperative complications, postoperative complications, conversions, reoperations and deaths. Results: There were 376 women, comprising 53.1% of the total and 332 men, representing 46.8%. The main pathologies responsible for the indication of fundoplication are heartburn and regurgitation in 530 patients (74.8%), followed by esophagitis in 151 patients (21.3%). Of the 530 patients with heartburn and regurgitation, 98% had hiatal hernia in the endoscopic evaluation. Main complications were pneumothorax (10% - 1.4%) and short vessel damage (10% - 1.4%). Four cases of conversion to laparotomic technique were added during the procedure (0.56%). There are 16 cases operated by clinical recurrent GERD (2.2%). Conclusion: A laparoscopic surgery at Nissen is a safe surgery, with good results. The correct surgical indication guarantees good results and low incidences of recurrences and post operative complications. The most frequent intraoperative complications do not imply an increase in morbidity and mortality. Late complications are uncommon and have the potential for seriousness.