Surgical endoscopy
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Comparative Study
Clinical and manometric results of laparoscopic partial (Toupet) and complete (Rosetti-Nissen) fundoplication.
It is unclear whether a partial or complete gastric fundoplication done laparoscopically will offer the best control of reflux with the fewest side effects. Prospective evaluation of laparoscopic Rosetti-Nissen (360) and Toupet (180) fundoplication was performed with assessment of clinical and manometric data. ⋯ In patients with severe GERD, laparoscopic Toupet and Rosetti-Nissen control symptoms and esophageal pH similarly. LES pressures are higher postop in the Rosetti-Nissen. Dysphagia and gas-bloat are more prevalent in the Nissen group. Laparoscopic Toupet fundoplication may be superior to Rosetti-Nissen in reducing the frequency of side effects frequently associated with antireflux surgery, yet with equal control of reflux.
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Diffuse bleeding from parenchymatous organs or bleeding of the lung both in conventional and endoscopic surgery has to this day been treated with the usual methods - coagulation, tamponade, or oversewing. ⋯ The application system, which consists of a fan as the Tachocomb carrier and a mounting support, worked well during the first tests. In order to confirm this, clinical studies will now be carried out.
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Biography Historical Article
Charles McBurney (1845-1913). Afield from the appendix.