Fundoplication Experience in three Private Centers in South Southern Nigeria.
Background.:Hiatal hernia is becoming a new face of treatment challenge in developing economy.
Most cases are associated with reflux disease. Anti-reflux surgery where indicated will be rewarding.
Aim.:This was to elucidate an experience of fundoplication performed by a single surgeon in three different centers in the developing economy.
Methodology: This was a review of a prospectively collected data of cases performed, stored electronically in Excel spread sheet and Epi-info from December 2019 to December, 2025. The review included Laparoscopic procedures and laparoscopy assisted performed. Most case were done in Immaculate Conception Endoscopy and Minimal Access Surgery specialist centre (ICEMASS), while five case were done at Prime medical consultants, one case at Maggie Memorial hospital/ meridian hospital.
The results were analyzed using SPSS version 25.
Results: A total of 78 cases were performed. Seventy-Five where laparoscopic fundoplication using Nissen method. Three were done via Laparoscopy assisted using Tourpet Method. The age range from 8 to 65 years with a mean age of 44.3 ± 8.1 years. Fourteen males and Sixty-four females with a M: F ration of 1:5. Most of the cases were done in 2025 with median duration of surgery of 2.5 ± 0.6 hours. Follow-up revealed complete resolution of symptom in 72 cases, one was lost on follow-up. Three cases experiences discomfort and still on follow-up. Two of the patients had dysphagia and had oesophageal balloon dilatation. One had oesophageal perforation and was managed conservatively. A case of esophago-gastric fistula following passage of nasogastric tube, was noted but this was treated with endoscopic clip application.
We observed that three patients who had Barret’s without dysplasia where found to have complete disappearance of Barrett’s post-operatively. 5 patients who presented through referral by Otorhinolaryngology also had resolution of their concurrent halitosis, tonsillitis and pharyngeal nodules. Table 1 showed yearly distribution of surgery while figure 1 and 2 showed pre and post operation pictures of hernia state. Figure 3 A and 3B showed the presence of Barrett’s in one of the patients.
Conclusion: This experience is quite minute but will add to literature, especially in developing economy.
Key words: Fundoplication surgery, experience, South Southern Nigeria.
