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What is Total Nissen's fundoplication is used for the surgical management of - and explain in detail?
Ans. is 'b' i.e., Gastroesophageal reflux Surgical management of Gastroesophageal reflux disease:* There are many operations for GORD, but they are virtually all based on the creation of an intra-abdominal segment of oesophagus, crural repair and some form of wrap of the upper stomach (fundoplication) around the intraabdominal oesophagus. The contribution of each component to operative success is widely debated, but it is clear that operations that fail to address all three components have inferior success rates.* Total Nissen's fundoplication used for the surgical management of GERD, tends to be associated with slightly more short-term dysphagia but is the most durable repair in terms of long-term reflux control.* Partial fundoplication, whether performed posteriorly (Toupet) or anteriorly (Dor, Watson), has fewer short- term side-effects at the expense of a slightly higher long-term failure rate.* One disadvantage of total fundoplication is the creation of an overcompetent cardia, resulting in the 'gas bloat' syndrome in which belching is impossible.