Fundoplication, laparoscopic according to Toupet

Anatomy Perioperative management Technique Complications Evidence Total Video

Content

Skin incision
Trocar positioning
Traction of the stomach and incision of the lesser omentum
Preparation of the diaphragmatic crura with entry into the mediastinum
Preparation of the lower esophagus
Mobilization of the gastric fundus
Posterior hiatoplasty
Shoeshinetest
Fixation of the fundus cuff I
Fixation of the fundus cuff II
Fixation linker fundus
Suture and Dressing

Authors

PD Dr. med. Hamid Mofid

Klinik Pinneberg

Prof. Dr. med. Carsten Zornig

Israelitisches Krankenhaus Hamburg

Date

date of publication: 25.04.2009
date of update: 20.08.2023

surgery report

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Skin incision

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A small skin incision is made well above the navel in the midline. After inserting the Veress needle and verifying the correct position, the pneumoperitoneum is established.
Trocar positioning

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The optics are introduced via a 5mm/10mm trocar. A diagnostic laparoscopy is performed. Under direct vision, 4 trocars are placed in the upper abdomen.
Traction of the stomach and incision of the lesser omentum

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The left liver lobe is held up with the laparoscopic probe and the stomach is tensed with the Babcock clamp. In the area of the pars flaccida, the lesser omentum is incised with the ultrasonic scalpel.
Preparation of the diaphragmatic crura with entry into the mediastinum

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Now the right diaphragmatic crus is displayed. Then, proceed anteriorly over the anterior commissure to the left diaphragmatic crus and display it as well. In doing so, the ventral mediastinum is opened.