Surgery Today

, Volume 42, Issue 6, pp 601–604 | Cite as

Early experience with single-incision laparoscopic Nissen fundoplication for gastroesophageal reflux disease in patients with mental retardation via a gastrostomy site incision: report of five cases

  • Masaru Mizuno
  • Megumi Kobayashi
  • Akira Sasaki
  • Jun Nakajima
  • Go Wakabayashi
Case Report


Single-incision laparoscopic fundoplication for gastroesophageal reflux disease is not widespread because of its technical difficulty. On the other hand, patients with gastroesophageal reflux frequently also have mental retardation and eating disorders. We have been performing single-incision laparoscopic fundoplication via a gastrostomy site incision since October 2009 for these patients. The treated patients were 4 males and 1 female. A small skin incision was made on the gastrostomy site and a SILS port was placed. Under pneumoperitoneum, a single-incision laparoscopic Nissen fundoplication and gastrostomy were performed with a flexible scope, conventional instruments, and high-dexterity instruments. The pneumoperitoneal time was 115–180 min and blood loss was 1–15 ml. There were no intra- or postoperative complications. The hospital stay was under 8 days for all patients. Using this procedure, the incidence of postoperative intestinal obstruction was very low. The results indicate this procedure can be used as a standard operation for these patients in the future.


Single-incision surgery Laparoscopy Fundoplication Gastroesophageal reflux 


Conflict of interest

Masaru Mizuno and co-authors have no conflicts of interest.


  1. 1.
    Navarra G, Pozza E, Occhionorelli S, Carcoford P, Donini I. One-wound laparoscopic cholecystectomy. Br J Surg. 1997;84:695.PubMedCrossRefGoogle Scholar
  2. 2.
    Piskun G, Rajpal S. Transumbilical laparoscopic cholecystectomy utilizes no incisions outside the umbilicus. J Laparoendosc Adv Surg Tech A. 1999;9:361–4.PubMedCrossRefGoogle Scholar
  3. 3.
    Canes D, Desai MM, Aron M, Haber GP, Goel RK, Stein RJ, et al. Transumbilical single port surgery. Eur Urol. 2008;54:1020–9.PubMedCrossRefGoogle Scholar
  4. 4.
    Esposito C. One-trocar appendectomy in pediatric surgery. Surg Endosc. 1988;12:177–8.CrossRefGoogle Scholar
  5. 5.
    Canes D, Desai MM, Aron M, Haber GP, Goel RK, Stein RJ, et al. Outcome after intra- and extra-corporeal laparoscopic appendectomy techniques. Surg Endosc. 2004;18:1123–5.Google Scholar
  6. 6.
    Remzi F, Kirat H, Kaouk J, Geisler D. Single-port laparoscopy in colorectal surgery. Colorectal Dis. 2008;10:823–6.PubMedCrossRefGoogle Scholar
  7. 7.
    Bucher P, Pugin F, Morel P. Single port laparoscopic colectomy. Colorectal Dis. 2009;11:101.PubMedCrossRefGoogle Scholar
  8. 8.
    Bucher P, Pugin F, Morel P. Single port access laparoscopic right hemicolectomy. Int J Colorectal Dis. 2008;23:1013–6.PubMedCrossRefGoogle Scholar
  9. 9.
    Bucher P, Pugin F, Morel P. Transumbilical single incision laparoscopic intracorporeal anastomosis for gastrojejunostomy. Surg Endosc. 2009;23:1667–70.PubMedCrossRefGoogle Scholar
  10. 10.
    Barbaros U, Dinccag A. Single incision laparoscopic splenectomy. J Gastrointest Surg. 2009;13:1520–3.PubMedCrossRefGoogle Scholar

Copyright information

© Springer 2012

Authors and Affiliations

  • Masaru Mizuno
    • 1
  • Megumi Kobayashi
    • 1
  • Akira Sasaki
    • 1
  • Jun Nakajima
    • 1
  • Go Wakabayashi
    • 1
  1. 1.Department of SurgeryIwate Medical UniversityMoriokaJapan

Personalised recommendations