Choosing Nissen or Toupet Fundoplication - Balancing Barrier vs Bolus

Send us Fan MailTo choose the appropriate surgery between Nissen and Toupet fundoplication, a structured preoperative assessment is essential to match the procedure to the patient's specific physiology and symptoms. The following tests are required:High-Resolution Manometry: This is a critical test used to evaluate esophageal body motility and exclude major motor disorders. It helps determine if a patient has ineffective motility or weak peristaltic reserve. While Nissen is favored for those with good esophageal peristalsis, Toupet is preferred when motility is impaired.pH Testing: This testing is used to confirm pathologic reflux and provide objective evidence of abnormal acid exposure. It is particularly important for patients being considered for a Nissen fundoplication, which is often selected for classic GERD with strong objective reflux evidence.Upper Endoscopy: This procedure is used to define mucosal disease and rule out complications such as strictures or Barrett’s esophagus. It also provides endoscopic evidence of reflux, which supports the decision for a Nissen wrap.Barium Swallow: This imaging test provides detailed information regarding hernia anatomy, esophageal clearance, and any structural narrowing. It is especially useful in cases involving large hiatal hernia repairs where the surgeon must decide on the extent of the wrap.Listen in to explore more. Don’t forget to check out out YouTube and Facebook page to enjoy more engaging contents. DISCLAIMER: This content is for reference only and you must follow local/standard guidelines in clinical practiceLike, share and subscribe.  Support the showQuick discussion and review of topics that interests you.