Laparoscopic Partial Fundoplication
Partial Fundoplication also known as Toupet Fundoplication is an anti-reflux procedure that is occasionally used to treat acid reflux in Lieu of Nissen fundoplication.
Like Nissen fundoplication, laparoscopic partial fundoplication surgery is performed under general anesthesia via five tiny incisions. Unlike Nissen fundoplication (360-degree wrap), the upper part of the stomach (fundus) is only partially wrapped around lower esophagus (270-degree wrap). Hence the name partial fundoplication. A partial wrap creates minimal resistance to food passage from esophagus into stomach. This is particularly useful in cases of poor or absent esophageal motility. The esophagus is too weak to push food against a full wrap. In rare cases, gastric fundus is too small to perform a floppy full wrap or Nissen fundoplication. In this situation, a partial wrap is offered to avoid post-operative dysphagia or difficulty swallowing.
Studies have shown that both partial and full wrap are equally effective in terms of acid reflux control. Several acid reflux surgeons prefer partial fundoplication over Nissen fundoplication for fear of post-operative dysphagia. At Houston Heartburn and Reflux center, post Nissen fundoplication dysphagia is extremely rare. Therefore, our most performed anti-reflux procedure is laparoscopic Nissen fundoplication. A 360-degree wrap is more robust than a partial wrap resulting in better durability and improved reliability.
Is partial fundoplication surgery appropriate for you?
At Houston Heartburn and Reflux Center, each patient receives thorough evaluation for heartburn and acid reflux including pre-operative manometry and UGI contrast study. Esophageal manometry accurately measures motility and lower esophageal sphincter pressure. Depending on these results, Dr. Darido will recommend the most appropriate treatment for you.