Passage of the a finger down behind the fascia helps in this move. Noone considered the other types of LES repair done through the esophagus because of the hernia. 1998 Jul;90(7):487-98. In the Nissen Group, intraoperative manometry (IOM) was carried out in all patients; in the Hill Group, the patients were randomized in two sub-groups (A and B), before operation; in 20 of them (group A), the procedure was randomly associated to IOM. RESULTS The overall complications were low in both groups (15.6% in the Nissen Group and 5% in the Hill Group, p = 0.1), and there was . Image, Download Hi-res Larger studies are underway to demonstrate the long-term durability of the hybrid Nissen-Hill procedure in the management of GERD. Tri-comparison of laparoscopic Nissen, Hill, and Nissen-Hill hybrid repairs for uncomplicated gastroesophageal reflux disease. Fundoplication: Uses, what to expect, and more - Medical News Today Results. We recognize that patients with diminished motility are at higher risk for postoperative dysphagia but feel confident that the unique ability of the Hill repair to adjust suture tension during surgery allows to obtain a less tight (albeit competent) repair in these patients. Each of these problems can be corrected by specific surgical procedures. The higher the sutures on the bundles, the tighter the repair, so large separations between each suture should be avoided. Upper gastrointestinal series is useful in cases of hiatal hernia and to evaluate stricture. For our system ideal pressure is 25 to 35 mm Hg. Still, up to 26% of Nissen fundoplication patients report postoperative persistence or recurrence of dysphagia, heartburn, and regurgitation. My manometry didn't show great peristalsis, but my barium swallow testing . They are tied over a 36F bougie plus NG tube with a single throw in the knot which is clamped. I can hardly blame their reluctance given my history. In this forum people are mentioning Nissen Fundoplication as a means of surgical relief but if you are considering surgery for GERD, you may want to get info on the Hill Repair as well. Nissen is a basic tightening of the Lower esophageal sphincter (LES) by wrapping the upper part of the stomach (fundus) around it. (Reprinted with permission.). When indicated, postoperative endoscopy (.