For those patients with gastroesophageal reflux disease (GERD) who don't respond well to medication or have persistent esophagitis, laparoscopic fundoplication is now a preferred method of treatment. An estimated 90% of fundoplication procedures were performed laparoscopically in 2009.²¹ As a result, the average length of stay in the hospital was reduced by 2.5 to 6 days in seven independent studies, compared with open surgery options.²⁰

And as more minimally invasive procedures become accepted, it becomes possible to carry out the procedure on an outpatient basis – it's estimated that 75% of laparoscopic fundoplication procedures will be outpatient by 2014, reducing medical costs for patients and providers and freeing up beds for more acute cases.¹⁵

We provide several devices and solutions that have proven valuable in these procedures:

ENDOPATH^® XCEL™ Trocars provide smooth and unencumbered laparoscopic access to the surgical site, with bladeless, dilating, and blunt-tip options.

The multifunctional HARMONIC ACE^® Curved Shears use ultrasonic vibrations to cut and coagulate with precision and minimal lateral thermal spread or minimal lateral tissue damage. It may be used to:

• Mobilize and expose the esophagus and fundus of the stomach using a combination of blunt dissection and transection of tissue attachments.
• Coagulate and cut the short gastric vessel as required to mobilize the stomach and enable the wrap around the esophagus. The HARMONIC ACE Curved Shears enables this to be accomplished with fewer instrument exchanges compared with clamp, clip, and cut methods.

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