الفهرس 
ANATOMICAL CONSIDERATIONSOnly 14 pages are availabe for public view
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Abstract
This study confirms that, the laparoscopic Nissen fundoplication to be a safe and effective treatment for patients with gastro-esophageal reflux (up to 90% of the patients report good to excellent control of their previous symptoms).
Data from This study have shown no significant difference between laparoscopic Nissen fundoplication with and without division of short gastric vessels as regard efficiency for control of GERD symptoms. Rossetti modification may be superior to the original Nissen as regard operative time but with the introduction of harmonic scalpel and the increase of our learning curve for this procedure, this makes the difference insignificant (but with increase in the cost factor which wasn’t measured in this study).
Also this study showed that short gastric vessel division is followed by a higher incidence of “wind” problems (inability to belch and increased flatus) while preserving them is associated with increased postoperative dysphagia but in both cases these complications are transient and self-limiting.
In conclusion, this short term study has shown that it is of no clinical importance whether or not the short gastric vessels are divided when performing a total fundoplication. With total fundoplication it makes no difference whether the fundus is mobilized or not. Both types of repair provide lasting control of GERD symptoms.