Comparative Study between Conventional Laparoscopic Nissen Fundoplication and Modified Nissen Fundoplication: A Prospective Randomized Controlled Trial.

Abstract

Background: Laparoscopic Nissen Fundoplication (NF) remains the gold standard anti-reflux procedure due to its well-established long-term efficacy and safety. However, the modified Nissen fundoplication (MNF) which incorporates additional sutures to fixate the esophagus to the right and left crus aims to enhance hiatal stabilization and potentially reduce GERD symptom recurrence.

Aim: This study aims to compare between conventional Laparoscopic Nissen Fundoplicalion and Modified Nissen Fundoplication regarding post-operative complications specially "Dysphagia, recurrence of GERD symptoms".

Patients and methods: This study is a prospective randomized controlled trial. The study took place at Ain Shams University Hospitals. The study was conducted from January 2023 to January 2025, including one year for patient recruitment and one year for follow-up.

Results: This study compared NF and MNF in terms of postoperative complications, revealing a statistically significant difference in the incidence of postoperative hiccups and left shoulder pain. While some prior studies found no significant differences between the two techniques, our results suggest that MNF can be performed safely by experienced surgeons without increased morbidity or complication rates.

Conclusion: The current study was constrained by its limited sample size and follow-up duration, which may affect the generalizability of findings. To further validate these results, future research should involve larger cohorts and extended follow-up periods to assess long-term recurrence rates and complications. Such data will help determine whether MNF offers superior outcomes over conventional NF, guiding clinical decision-making for optimal surgical management of GERD.