Abstract

Aim: Laparoscopic approach to fundoplication for gastroesophageal reflux disease has become an established procedure in infants and children. This study aims to evaluate our experience with laparoscopic Nissen fundoplication and gastrostomy in a developing country.

Methods: We reviewed the records of 13 consecutive laparoscopic Nissen fundoplication with or without gastrostomy performed by a single surgeon at our institution. All patients had documented gastroesophageal reflux disease with ages ranging from 8 months to 15.2 years. All were followed clinically for the presence of early or late postoperative complications including recurrent reflux.

Results: In 10 of the 13 children, Nissen fundoplication was completed laparoscopically, 3 needed conversion to open technique. An average operative time of 182 minutes was noted with a decreasing trend over time. No postoperative complications like need for postoperative ventilation, bowel disturbances and pulmonary complications were seen. Long term follow up showed all patients thriving, without need for antacid medication. Encouragingly, high parental satisfaction was seen both for the procedure as well as for results of surgery.

Conclusion: Laparoscopic Nissen fundoplication is an effective treatment option for children in our hands. There is high parental satisfaction with the procedure.

Keywords: Gastroesophageal reflux disease; Laparoscopy; Fundoplication; Gastrostomy