Minimally invasive surgery continues to evolve, with an emphasis on developing new techniques and applying new technology to surgical procedures. The purpose of this study was to compare the short-term outcomes of needlescopic fundoplication with those of conventional laparoscopic fundoplication.
Between January 1999 and June 2000, 38 needlescopic fundoplications were performed, and the short-term outcomes for these patients were compared with those for a contemporary matched cohort of patients who had undergone a conventional laparoscopic fundoplication.
There was a nonsignificant trend toward decreased operative time (143.4 to 127 min; p=0.13), blood loss (54.3 to 48 ml; p=0.30), narcotic requirements (29.5 to 19.5 morphine equivalents; p=0.32), and length of hospital stay (1.78 to 1.49 days; p=0.10) in the needlescopic group. There were no significant differences in intraoperative complications (2.6% vs 2.6%; p=1.0). Two needlescopic cases were converted to laparoscopic cases because of obesity. Postoperatively, there were no significant differences in rates of early dysphagia (7.9% vs 7.9%), bloating (13.2% vs 5.3%; p=0.43), or other complications (5.3% vs 5.3%) between the groups. There was a significant reduction in mean operative time for needlescopic fundoplication after the first four cases (166±44 vs 120±32 min; p=0.03).
Needlescopic fundoplication poses no disadvantage, and it offers the added cosmetic benefit of smaller incisions.
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Pace, D.E., Chiasson, P.M., Schlachta, C.M. et al. Needlescopic fundoplication. Surg Endosc 16, 578–580 (2002). https://doi.org/10.1007/s00464-001-8213-8
- Laparoscopic procedures
- Nissen fundoplication