Proper Orientation of the Fundic Wrap
The fundoplication is sutured in place with a single U-stitch of 2–0 Prolene pledgeted on the outside. A 60-French mercury-weighted bougie is passed through the gastroesophageal junction prior to fixation of the wrap to assure a floppy fundoplication. Ins
Bagcock Clamp
A. Placement of Babcock clamp on the posterior fundus in preparation for passing it behind the esophagus to create the posterior or right lip of the fundoplication. To achieve the proper angle for passage, place the Babcock through the left lower trocar.
Patient Position and Room Setup
Patient positioning and room setup for laparoscopic fundoplication. The patient is placed with the head elevated 45 degrees in the modified lithotomy position. The surgeon stands between the patient’s legs. One assistant, on the surgeon’s right, retracts