Fundoplication (Dor/Toupet/Nissen)

Nissen fundoplication is a surgical procedure used to treat GERD (gastroesophageal reflux disease) and hiatal hernias. During the procedure, the top of the stomach (the fundus) is wrapped around the lower part of the esophagus and sutured into place around the esophagus. The Nissen fundoplication is a 360-degree wrap around the esophagus, which can effectively prevent the reflux of stomach acid into the esophagus.

Toupet fundoplication is a less extensive anti-reflux procedure compared to the Nissen fundoplication. It involves a 270-degree posterior fundoplication, meaning that partial wrapping of the upper portion of the stomach around the lower part of the esophagus is performed. The Toupet fundoplication is sometimes chosen for patients who may be at risk for postoperative dysphagia (difficulty swallowing) after a Nissen fundoplication.

Dor fundoplication is another variation of the anti-reflux procedure, involving a 180-degree anterior fundoplication. It is a partial wrap technique in which the front portion of the stomach is wrapped around the esophagus to create a valve. This procedure aims to provide effective reflux control while minimizing the risk of postoperative dysphagia.

Each type of fundoplication surgery has its own specific characteristics and considerations, and the choice of procedure depends on the individual patient's condition and factors such as the extent of reflux, the presence of a hiatal hernia, and the potential for postoperative side effects. It's important for patients to consult with a qualified surgeon to determine the most suitable approach for their specific needs.