Work

Revisiting Short Gastric Division for Laparoscopic Nissen Fundoplication: A Literature Review

Year: 2025

Type: article

Abstract: The debate continues over whether short gastric vessels (SGVs) should be divided during laparoscopic Nissen fundoplication (LNF) to alleviate the wrap tension. This study aimed to narratively compile evidence from laparoscopic-only studies (2005-2025) that compared the effects of dividing versus preserving the SGVs on dysphagia, gas-bloat syndrome, and reflux recurrence. We synthesized randomized trials, meta-analyses, and guidelines published between 2005 and 2025 comparing SGV division versus preservation. Across long-term randomized follow-up and multiple meta-analyses, routine SGV division did not reduce dysphagia or improve reflux outcomes. It was associated with more gas-bloat and slightly longer operative time. In contemporary LNF, using a standardized technique, routine SGV division is unnecessary, and selective division is reserved for cases with clear tension.

Source: Cureus

DOI: 10.7759/cureus.96724

Authors: Mostafa Mahran, Oday Al-Asadi, Almoutuz Aljaafreh, Rofida Sobh

Institutions: Homerton University Hospital, King's College Hospital, Ain Shams University

Language: English

Topic: Gastroesophageal reflux and treatments

Subfield: Gastroenterology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W4416159945