Single Incision Laparoscopic Fundoplication : Using Conventional Trocars and Instruments

C Palanivelu, P Senthilnathan, P Praveen Raj, R Parthasarthi, P S Rajan, V Vaithiswaran. GEM Hospital & Research Centre

 

Background:
With accumulating evidence on Single Incision Laparoscopic Surgery we now know that this technique can be applied to even many advanced procedures.Floppy Nissen Fundoplication is a well accepted procedure for treatment of GERD and Symptomatic Hiatus Hernia. There is some evidence on Single Incision Nissen Fundoplication. But the main drawback of this technique is the increased cost factors considering the port devices and specialised instrumentation required.Here in this video we will be demonstrating our technique of Single Incision Fundoplication using conventional trocars and regular straight instruments.

Video:
In this high Definition video, we demonstrate our technique of Single Incision Fundoplication
The steps are as follows,
– Creation of umbilical flaps by cutting into the umbilicus.
– Creating pneumoperitoneum using a Veress needle
– Placement of one 10mm and two 5 mm trocars at some distance between each other.
– Liver retraction using a novel liver suspension technique using straight needles and a corrugated drain.
– Mobilization of the fundus and the lower end of Esophagus after creating the retro esophageal window.
– Closure of the hiatal defect with 1 Ethilon sutures
– Creation of a loose fundal wrap around the lower end of esophagus and anchoring it to the hiatus.

Conclusion;

Single incision Nissen’s fundoplication is very much possible and cost can be reduced with the use of conventional laparoscopic instruments and direct multipuncture technique


Session Number: VidTV3 – Video Channel Rotation Day 3
Program Number: V133

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