How is 360-degree wrap?

• Laparoscopic Nissen fundoplication • The procedure of choice for the majority of patients • This approach provides a direct and early view of the short gastric vessels and spleen • Early mobilisation of the fundus • Right crural dissection is then performed by opening the lesser omentum. • Dissection of the right crus reveals the dissected left crus • Care must be taken to preserve the vagi which will be contained by the wrap • A Penrose drain is placed around the esophagus to facilitate more proximal dissection and to assist in creating a wrap • The crura are approximated posteriorly using interrupted nonabsorbable stitches to allow the passage of a 52-Fr. bougie