Laparoscopic Toupet fundoplication - general and visceral surgery

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  • Skin incision

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    Skin incision
     

    One midline skin incision markedly superior to the umbilicus. After having introduced the Verres needle and checked its correct position, establish the pneumoperitoneum.

  • Trocar positioning

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    Trocar positioning
     

    Introduce the laparoscope with attached camera through a 5 mm/10 mm trocar. Perform a diagnostic laparoscopy. Introduce 4 epigastric trocars under direct visual control.

  • Extending the stomach and incising the omentum

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    Extending the stomach and incising the omentum
     

    Lift up the left hepatic lobe with the exploratory probe and tense the stomach with the Babcock clamp. Incise the flaccid portion of the lesser omentum with the harmonic scalpel.

  • Exposing the diaphragmatic crura and entering the mediastinum

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    Exposing the diaphragmatic crura and entering the mediastinum
     
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  • Mobilizing the gastric fundus

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  • Exposing the lower esophagus

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  • Posterior hiatoplasty

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  • Shoeshine maneuver

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  • Fixating the fundus cuff I

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  • Fixating the fundus cuff II

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  • Fixating the left fundus

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  • Closure and dressing

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  1. Skin incision
  2. Trocar positioning
  3. Extending the stomach and incising the omentum
  4. Exposing the diaphragmatic crura and entering the mediastinum
  5. Mobilizing the gastric fundus
  6. Exposing the lower esophagus
  7. Posterior hiatoplasty
  8. Shoeshine maneuver
  9. Fixating the fundus cuff I
  10. Fixating the fundus cuff II
  11. Fixating the left fundus
  12. Closure and dressing
date of update: 14.07.2018
date of publication: 25.04.2009

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