Laparoscopic Nissen Fundoplication
The upper stomach (fundus) is wrapped 360° around the lower oesophagus to create a one-way valve — the gold-standard surgical cure for severe GERD.
What is Laparoscopic Nissen Fundoplication?
Laparoscopic Nissen fundoplication is the gold-standard surgical treatment for severe gastro-oesophageal reflux disease (GERD) and large hiatal hernias. Through five small keyhole ports, the hiatal hernia (if present) is repaired, the lower oesophagus is mobilised, and the upper stomach (fundus) is wrapped 360° around the lower oesophagus. This creates a one-way valve that prevents acid reflux while still allowing food to pass. Dr. Abhishek performs Nissen fundoplication at Lux Hospitals for patients tired of lifelong PPI medication or with PPI-resistant reflux.
How the Procedure Works
Anaesthesia & Pneumoperitoneum
General anaesthesia is given; CO2 insufflation creates working space; five small ports are placed.
Hiatal Hernia Repair
The hernia sac is reduced; oesophagus is mobilised; crural defect is closed with non-absorbable sutures.
Fundic Mobilisation
Short gastric vessels are divided to fully mobilise the fundus for tension-free wrap.
360° Wrap
The fundus is brought behind the oesophagus and wrapped 360° around it; secured with three sutures.
Closure
Ports are removed under vision; small skin incisions are closed with absorbable sutures.
Outcomes
Who Needs This Treatment?
- →Definitive cure for GERD — no more lifelong PPIs
- →Repairs hiatal hernia simultaneously
- →Long-term symptom relief in 85–90% of patients
- →Five small keyhole incisions — minimally invasive
- →Prevents progression to Barrett's oesophagus
- →Resolves regurgitation that medications cannot fix
Nissen fundoplication transforms patients who have lived with severe reflux for years — they wake up able to lie flat, eat dinner late, and stop taking acid-suppressing medication forever. It's a genuinely life-changing operation.
— Dr. Abhishek Katha, Consultant General & Advanced Laparoscopic Surgeon, Lux Hospitals, Hyderabad
Laparoscopic Nissen Fundoplication Cost in Hyderabad
The cost of laparoscopic Nissen fundoplication in Hyderabad depends on the severity and duration of gastroesophageal reflux disease (GERD), response to medical treatment, presence and size of a hiatal hernia, esophageal function, pre-operative investigations, surgical complexity, anesthesia, and hospital stay. Laparoscopic Nissen fundoplication is an anti-reflux procedure in which the upper part of the stomach is wrapped around the lower esophagus to create a 360-degree fundoplication and strengthen the barrier against acid reflux. It may be considered for selected patients with objectively confirmed reflux symptoms that remain troublesome despite appropriate medical management. The estimated cost ranges from ₹1,50,000 to ₹2,80,000, with an average cost of approximately ₹2,15,000.
| Procedure | Approximate Cost Range |
|---|---|
| Refractory GERD, 360 degree wrap | ₹1,50,000 ₹2,80,000 |
The actual cost may vary depending on the severity of GERD, presence and size of a hiatal hernia, esophageal anatomy and motility, previous upper abdominal surgery, and the complexity of the laparoscopic repair. The final expense may include consultation, upper GI endoscopy, blood investigations, esophageal manometry, ambulatory 24-hour pH or impedance-pH monitoring, imaging when indicated, anesthesia, operating-room charges, hospital admission, medicines, and follow-up care.
Pre-operative testing is an important part of planning anti-reflux surgery. Esophageal manometry and ambulatory reflux testing are commonly used to confirm objective reflux and assess esophageal function before surgery, particularly when the diagnosis or suitability for fundoplication needs to be established. Based on the provided estimate, manometry and a 24-hour pH study together may cost approximately ₹15,000–₹30,000 and may be billed separately. LINX Magnetic Sphincter Augmentation is a separate device-based treatment available only for selected patients and should not be assumed to be included in the Nissen fundoplication estimate.
Factors Affecting Laparoscopic Nissen Fundoplication Cost
The cost of Nissen fundoplication can vary between patients because reflux disease, hiatal hernia anatomy, and esophageal function differ. The extent of pre-operative testing and whether a hiatal hernia requires repair during the same operation can have a significant effect on the overall treatment expense.
- →
Severity and persistence of GERD: Persistent symptoms despite appropriate medical treatment may require more detailed evaluation before surgery.
- →
Objective confirmation of reflux: Ambulatory pH or impedance-pH monitoring may be used to establish abnormal acid or non-acid reflux before an operative approach is selected.
- →
Esophageal motility: Manometry helps assess esophageal function and is an important part of surgical planning for anti-reflux procedures.
- →
Hiatal hernia: The presence and size of a hiatal hernia may require repair along with fundoplication and can increase operative complexity.
- →
Endoscopy findings: Upper GI endoscopy may be required to assess esophagitis, narrowing, Barrett's esophagus, or other upper GI abnormalities.
- →
Pre-operative testing costs: Manometry and 24-hour pH testing may add approximately ₹15,000–₹30,000 based on the provided estimate and may be billed separately.
- →
Surgical complexity: Adhesions, previous upper abdominal surgery, altered anatomy, or a large hiatal hernia can make laparoscopic surgery more technically demanding.
- →
Fundoplication technique: The Nissen procedure involves a complete 360-degree wrap, with the exact surgical plan tailored to the patient's anatomy and esophageal function.
- →
Anesthesia and hospital care: General anesthesia, operating-room charges, inpatient admission, nursing, monitoring, and recovery services contribute to the total cost.
- →
Additional procedures: Hiatal hernia repair or other clinically indicated treatment performed during the same operation can increase the final expense.
- →
Conversion or extended surgery: Difficult anatomy or unexpected findings may require additional operative time or a different surgical approach.
- →
Post-operative care: Medicines, dietary progression, follow-up consultations, and management of swallowing or other recovery-related symptoms may also affect the overall cost.
Insurance Coverage for Laparoscopic Nissen Fundoplication
Laparoscopic Nissen fundoplication may be covered by health insurance when it is medically necessary for objectively documented GERD or hiatal hernia and meets the insurer's treatment criteria. Coverage depends on the diagnosis, medical indication, prior treatment history, policy terms, waiting periods, exclusions, insurer guidelines, applicable limits, and pre-authorization requirements. Coverage for manometry, pH monitoring, endoscopy, anesthesia, hospitalization, and hiatal hernia repair may be governed by separate policy provisions. Patients should confirm the applicable benefits and cashless eligibility with their insurance provider before planned admission.
- Checking your policy coverage
- Cashless approval process
- Required documentation
- Insurance-related queries before the procedure
Dr. Abhishek Katha
Consultant General & Laparoscopic Surgeon
Dr. Abhishek Katha, Consultant General & Advanced Laparoscopic Surgeon at Lux Hospitals, Hyderabad, evaluates patients with GERD, hiatal hernia, and other upper gastrointestinal surgical conditions. During consultation, he reviews symptoms such as heartburn, acid regurgitation, chest or upper abdominal discomfort, symptoms after meals, night-time reflux, difficulty swallowing, chronic cough or throat symptoms where relevant, duration of symptoms, response to medicines, and previous gastrointestinal treatment. He also reviews endoscopy findings, esophageal manometry, ambulatory pH or impedance-pH monitoring, imaging, and other diagnostic reports to determine whether reflux has been objectively demonstrated and whether the patient's esophageal function and anatomy are suitable for surgical treatment. When laparoscopic Nissen fundoplication is being considered, Dr. Abhishek Katha assesses the severity of reflux, presence of a hiatal hernia, esophageal motility, and other clinical factors that can affect the choice of anti-reflux procedure. He explains the 360-degree fundoplication, the possibility of repairing a hiatal hernia during the same operation, preparation before surgery, expected hospital stay, recovery and dietary progression, and potential post-operative swallowing or gas-related symptoms. He can also discuss alternative treatment approaches such as other forms of fundoplication or selected device-based options, along with the separate cost of pre-operative testing, possible additional procedures, follow-up requirements, and the estimated overall treatment expense.
Consultation with Dr. Abhishek Katha Consultation with Dr. Abhishek KathaCommon Questions
Frequently Asked Questions
Not sure which treatment is right for you?
Book a consultation with Dr. Abhishek Katha and get a personalised treatment plan.