Mechanism:

Nissen fundoplication involves wrapping the upper stomach around the lower esophagus, forming a 360-degree collar-like structure. This wrap reinforces the LES, creating a robust barrier against stomach acid reflux.

Types of Nissen Fundoplication:

1. Full Fundoplication: Wraps the esophagus entirely.
2. Partial Fundoplication: Offers reflux relief with variations like anterior and posterior fundoplication, aiming to minimize post-surgical swallowing difficulties.

Considerations:

• Patient Selection: Ideal for those with persistent GERD despite medical management.
• Preoperative Evaluation: Comprehensive assessments ensure optimal surgical outcomes, including imaging studies and esophageal motility evaluations.
• Potential Risks: While generally safe, risks include swallowing difficulties and gas bloating, balanced against potential benefits during decision-making.
• Postoperative Care: Involves dietary and lifestyle modifications to support healing, emphasizing smaller, more frequent meals.