Traditional fundoplication to treat oesophageal reflux has been carried out laparoscopically via an abdominal approach. An alternative is the laparoscopic use of a mobilised falciform ligament to wrap around the oesophagus: a ligamentum teres cardiopexy. Both techniques are still not widely established, but they offer considerable advantage to the patient, e.g. decreased pain and increased cosmesis.
Indications for laparoscopic anti-reflux procedures include:
- intractable oesophagitis
- failure of medical therapy
- onset of complications, e.g. Barrett's oesophagus
- chronic anaemia
- prior vagotomy or partial gastrectomy
- an enlarged left lobe of the liver as the laparoscopic field of view is reduced
- oesophageal shortening
Potential complications include injury to any of the organs in the vicinity, pneumothorax and 'gas bloat syndrome' due to excessive constriction of the oesophagus.