World Journal of Laparoscopic Surgery

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VOLUME 16 , ISSUE 2 ( May-August, 2023 ) > List of Articles


Reproducible “Wrap” in Laparoscopic Fundoplication

Ganesh Shenoy, Sanjay Natarajan, Karthik Arabilachi Sambashivam, Ramesh Bramhavara Shambhurao

Keywords : Antireflux surgery, Geometry of wrap, Laparoscopic Nissen fundoplication, Laparoscopic Toupet fundoplication, Wrap

Citation Information : Shenoy G, Natarajan S, Sambashivam KA, Shambhurao RB. Reproducible “Wrap” in Laparoscopic Fundoplication. World J Lap Surg 2023; 16 (2):114-117.

DOI: 10.5005/jp-journals-10033-1579

License: CC BY-NC 4.0

Published Online: 20-12-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Aim: The aim was to develop a simplified technique of correct wrap creation that is reliable, easy, and reproducible so that failure of antireflux surgery due to wrong wrap creation is prevented. Background: Improper creation of the wrap is one of the causes of failure of antireflux surgery. Anatomical failures in wrap creation cause morbidity to the patient and will require reoperations. There is a need to standardize this technique so that correct floppy wrap with respect to the site of creation on the fundus of the stomach, position, and length of the wrap can be achieved. Technique: The anterior wall and posterior wall of the fundus of the stomach are marked by silk sutures to aid in the creation of a 360-degree Nissen or a 270-degree Toupet wrap. This results in symmetry of the wrap on both sides, ensuring a floppy wrap with exact position and length. We have performed 20 cases of antireflux surgery (ARS) using this technique of wrap creation between January 2022 to September 2022. There was no recurrence of reflux symptoms, dysphagia or wrap failure requiring endoscopy or redo surgery in the postoperative period. Conclusion: This technique of wrap creation is safe, reliable, easy to learn, teach, and is reproducible during laparoscopic Nissen (LN) and laparoscopic Toupet (LT) fundoplication. Clinical significance: Our technique helps to standardize wrap creation in antireflux surgery. This results in a lesser chance of failure due to wrong wrap creation.

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