Single-site Nissen fundoplication versus laparoscopic Nissen fundoplication.

Sharp, Nicole E; Vassaur, John; Buckley, F Paul

BACKGROUND Advances in minimally invasive surgery have led to the emergence of single-incision laparoscopic surgery (SILS). The purpose of this study is to assess the feasibility of SILS Nissen fundoplication and compare its outcomes with traditional laparoscopic Nissen fundoplication. METHODS This is a retrospective study of 33 patients who underwent Nissen fundoplication between January 2009 and September 2010. RESULTS There were 15 SILS and 18 traditional laparoscopic Nissen fundoplication procedures performed. The mean operative time was 129 and 182 minutes in the traditional laparoscopic and single-incision groups, respectively (P=.019). There were no conversions in the traditional laparoscopic group, whereas 6 of the 15 patients in the SILS group required conversion by insertion of 2 to 4 additional ports (P=.0004). At short-term follow-up, recurrence rates were similar between both groups. To date, there have been no reoperations. CONCLUSIONS SILS Nissen fundoplication is both safe and feasible. Short-term outcomes are comparable with standard laparoscopic Nissen fundoplication. Challenges related to the single-incision Nissen fundoplication include overcoming the lengthy learning curve and decreasing the need for additional trocars.