Procedure used to treat gastroesophageal reflux and/or hiatal hernia by reestablishing a gastroesophageal angle and creating a barrier to intrathoracic gastric displacement. Most of this is accomplished by the Nissen technique by wrapping the fundus about the gastric cardia. This procedure may be performed laparoscopically as well as by open surgery in adults, children, or infants.

Belsey fundoplication

A surgical procedure for hiatal hernia with gastroesophogeal reflux that relies on the repair of three quarters of the circumference about the gastroesophageal sphincter.

Nissen fundoplication

The surgical correction of an esophageal hiatal hernia or gastroesophageal reflux, by wrapping the gastric cardia with adjacent portions of the gastric fundus. This procedure, which is frequently performed laparoscopically, reestablishes the gastroesophageal angle, enhances the lower esophageal sphincter, and prevents intrathoracic displacement of the stomach.

The patient is prepared physically and psychologically for surgery, and postsurgical procedures to be expected are explained. Vital signs and fluid intake and output, including wound and nasogastric tube drainage (if used) should be checked and recorded. Postoperative care includes attention to oral hygiene; care of chest tube thoracostomy (if a thoracic approach was employed); pain assessment and management; and incentive spirometry, deep breathing and coughing to prevent atelectasis or pneumonia. Before hospital discharge, dietary restrictions should be reviewed with the patient, and small, frequent meals recommended. Lifting, straining, and other activities that would increase intra-abdominal pressure should be avoided for about 5 weeks. Follow-up care should be scheduled.