A 50-year-old male presents with chronic heartburn, regurgitation, and hoarseness. 24-hour ambulatory esophageal pH monitoring confirms abnormal acid exposure. If the patient fails optimal medical therapy with proton pump inhibitors, what is the standard antireflux surgical procedure of choice?

Answer and explanation

Correct answer: B. Laparoscopic Nissen fundoplication (360-degree wrap)

  1. Step 1: Laparoscopic Nissen fundoplication is the surgical gold standard for medically refractory gastroesophageal reflux disease (GERD) or large hiatal hernias.
  2. Step 2: It involves mobilizing the gastric fundus and wrapping it 360 degrees around the lower esophagus to reinforce the lower esophageal sphincter (LES) mechanism.
Answer
Laparoscopic Nissen fundoplication (360-degree wrap).
Why not the others: 'Subtotal gastrectomy with Billroth II reconstruction' is indicated for gastric malignancy or refractory ulcer disease; 'Truncal vagotomy and pyloroplasty' was historically used for peptic ulcer disease to reduce acid secretion; 'Transoral incisionless diverticulectomy' treats Zenker's diverticulum.

Practise more General Surgery and Emergency Management.

Free questions with an explanation for every one, and full timed Oman Medical Specialty Board Examination (OMSB) mock tests.

All General Surgery and Emergency Management questionsTake a mock test

More General Surgery and Emergency Management questions