TOUPET FUNDOPLICATION PROCEDURE

The Toupet Fundoplication was first described by Dr. Andre Toupet in 1963.  Since then, it has become an established Minimally Invasive anti-reflux procedure.  Dr. Chiasson offers this procedure as one of the treatment options for those individuals seeking a solution to their issues with GERD/LPRD.

What is the Toupet Fundoplication?

The Toupet Fundoplication is a Minimally Invasive Anti-Reflux procedure.  It is performed using small incisions and involves freeing the lower esophagus and upper stomach.  The upper portion of the stomach is then brought around/ behind the esophagus.  The stomach is then sutured to the wall of the esophagus at the 10:00 and 2:00 positions.  This creates a wrap of roughly 270 degrees around the esophagus.  The appearance of the Toupet Fundoplication is similar to that of a hot dog bun. 

 

Why was the Toupet Fundoplication developed?

The Toupet Fundoplication was initially developed as an alternative to the Nissen/Total fundoplication.   The Nissen Fundoplication was associated with significant difficulty swallowing food and then significant difficult with belching and vomiting causing gas/bloat syndrome.  The proponents of the Toupet/Partial Fundoplication argued that it resulted in both less difficulty swallowing and more ability to vent/belch air without compromising acid reflux control.  In recent years, with the development of more sophisticated evaluation of our patients and the addition of new procedure options, its role in anti-reflux surgery is becoming better understood.

 

How does the Toupet Fundoplication work?

The Toupet Fundoplication works to reinforce the lower esophageal sphincter (LES) pressure.  The wrap is placed around the lower end of the esophagus.  When an individual swallows air, liquid, or food; the wrap fills and transmits pressure around the esophagus.

 

Who is a candidate for a Toupet Fundoplication?

The Toupet Fundoplication is generally used for patients with poor esophageal function.  It is also used for patients with a normal esophageal function who either can’t have or don’t want a LINX procedure.

 

What should you expect after a Toupet Fundoplication?

The Laparoscopic Hiatal Hernia / Toupet operation is generally an outpatient procedure.  It is performed under general anesthesia.  I use the latest pain and nausea control techniques and most patients experience minimal symptoms afterward.  Most individuals are able to eat normally within a few weeks of the surgery.  In general, everyone learns how to eat slowly and chew their food well!

 

Advantages of the Toupet Fundoplication?

The Toupet Fundoplication has an important to play in patients with GERD/LPRD who have a poor esophageal function or those for which the LINX device is not appropriate. 

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