✦ Toupet Fundoplication

Toupet Fundoplication

Q: When is Toupet preferred over Nissen?

Toupet is preferred for documented weak oesophageal motility, scleroderma-related reflux, prior gastric surgery affecting motility, and patients at high risk of post-op dysphagia. Otherwise Nissen remains the gold standard for severe GERD.

Q: Is reflux control as good?

Slightly less complete than Nissen — about 80–85% versus 85–90% long-term. The trade-off is fewer side effects (less dysphagia, less gas-bloat). Patient selection makes the difference.

Q: What about belching after Toupet?

Belching is usually preserved after Toupet, unlike Nissen where some patients lose the ability to belch. This is a significant advantage for patients prone to bloating or aerophagia.

Q: Can a Toupet be converted to Nissen later?

Yes — if reflux control is inadequate over time, Toupet can be converted to Nissen at re-operation. Most patients with appropriate Toupet selection do well long-term and don't need conversion.

A 270° partial posterior wrap of the fundus around the oesophagus — provides reflux control with less risk of gas-bloat and dysphagia than the full Nissen.

90–150 min PROCEDURE

2–3 Days HOSPITAL STAY

80–85% SUCCESS RATE

2–3 Weeks RECOVERY

What is Toupet Fundoplication?

Toupet fundoplication is a partial 270° posterior wrap of the gastric fundus around the lower oesophagus — an alternative to the full 360° Nissen wrap for patients with weak oesophageal motility or those at higher risk of dysphagia and gas-bloat. The partial wrap controls reflux while allowing easier passage of food and gas. Dr. Abhishek performs Toupet fundoplication at Lux Hospitals for patients with documented motility problems, mild GERD with hiatal hernia, or as a tailored alternative when full Nissen wrap is not ideal.

How the Procedure Works

Anaesthesia & Port Placement

General anaesthesia is given; five laparoscopic ports are placed in the upper abdomen.

Hiatal Repair & Mobilisation

Hiatal hernia is reduced; oesophagus is mobilised; crura are approximated with sutures.

Fundic Mobilisation

Short gastric vessels are divided to free the fundus for posterior wrap.

270° Posterior Wrap

The fundus is wrapped 270° around the back of the oesophagus, leaving the anterior 90° free.

Wrap Fixation

The wrap is sutured to the right and left side of the oesophagus and to the right crus.

Outcomes

90–150 minDURATION

2–3 DaysHOSPITAL STAY

80–85%SUCCESS RATE

Who Needs This Treatment?

→Lower risk of dysphagia compared to full Nissen wrap
→Reduced gas-bloat and difficulty belching
→Ideal for patients with weak oesophageal motility
→Effective reflux control in the right patient
→Five small laparoscopic ports — minimally invasive
→Tailored option when 360° wrap is not ideal

Toupet wrap is about matching the operation to the patient — for those with weaker oesophageal motility or who would suffer with a tight Nissen, the 270° partial wrap delivers good reflux control with fewer side effects.

— Dr. Abhishek Katha, Consultant General & Advanced Laparoscopic Surgeon, Lux Hospitals, Hyderabad

Common Questions

Frequently Asked Questions

When is Toupet preferred over Nissen?+

Is reflux control as good?+

What about belching after Toupet?+

Can a Toupet be converted to Nissen later?+

Not sure which treatment is right for you?

Book a consultation with Dr. Abhishek Katha and get a personalised treatment plan.

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