Transthoracic Gastroplasty (Collis) and Nissen Fundoplication

  • Jameson L. Chassin


As discussed in the previous chapters (see esp. Chap. 66), this operation is indicated in patients with reflux esophagitis that has caused a significant degree of fibrosis, constriction, and shortening of the esophagus. In some patients without much esophageal shortening, advanced fibrosis itself will interfere with the antireflux efficiency of a fundoplication because the rigid esophageal walls will not be compressed by the fundoplication. For this reason, Pearson and Henderson; Urschel, Razzuk, Wood, Galbraith et al.; and Orringer and colleagues (see Chap. 66) believe that almost every esophageal stricture caused by reflux should be treated by a Collis gastroplasty and an antireflux procedure. A previous high subtotal gastrectomy generally contraindicates a Collis gastroplasty. Most patients with recurrent reflux esophagitis after a previous operation will require a thoracoabdominal Collis—Nissen operation. This operation is indicated whenever the esophagogastric junction cannot without tension be brought down to the level of the median arcuate ligament.


Vagus Nerve Staple Line Esophagogastric Junction Proximal Stomach Left Gastric Artery 
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  1. Orringer MB, Orringer JS (1982) The combined Collis—Nissen operation: early assessment of reflux control. Ann Thorac Surg 33: 534PubMedCrossRefGoogle Scholar
  2. Orringer MB, Sloan H (1978) Combined Collis—Nissen reconstruction of the esophagogastric junction. Ann Thorac Surg 25: 16PubMedCrossRefGoogle Scholar
  3. Pearson FG, Henderson RD (1973) Experimental and clinical studies of gastroplasty in the management of acquired short esophagus. Surg Gynecol Obstet 136: 737PubMedGoogle Scholar
  4. Urschel HC, Razzuk MA, Wood RE, Galbraith NF, et al. (1973) An improved surgical technique for the complicated hiatal hernia with gastroesophageal reflux. Ann Thorac Surg 15: 443PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1984

Authors and Affiliations

  • Jameson L. Chassin
    • 1
    • 2
    • 3
    • 4
    • 5
  1. 1.New York University School of MedicineUSA
  2. 2.Booth Memorial Medical CenterFlushingUSA
  3. 3.University Hospital, New York University Medical CenterUSA
  4. 4.New York Veterans Administration HospitalUSA
  5. 5.Bellevue HospitalUSA

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