✦ PARTIAL ANTI-REFLUX WRAP

Toupet Fundoplication

Q: How is Toupet different from Nissen?

Nissen creates a full 360° wrap, while Toupet creates a 270° partial wrap. Toupet has slightly less reflux control but significantly less swallowing difficulty, making it preferable in select patients.

Q: When is Toupet preferred?

Toupet is preferred for patients with weak oesophageal motility, those at higher risk of post-operative swallowing problems, or those wanting to preserve the ability to belch and vomit normally.

Q: Will I be able to stop acid medications?

Most patients are able to stop or significantly reduce acid medications after Toupet fundoplication. Reflux control is excellent in over 85% of patients.

Q: Are there any long-term restrictions?

Most patients return to normal eating and lifestyle within a few weeks. Avoiding very large meals, carbonated drinks early on, and lying down immediately after eating helps maintain results.

A 270° partial wrap of the upper stomach around the lower oesophagus — effective alternative to Nissen fundoplication, with less risk of post-operative swallowing difficulties.

90–120 min PROCEDURE

1–2 Days HOSPITAL STAY

>85% SYMPTOM RELIEF

1–2 Weeks RETURN TO WORK

What is Toupet Fundoplication?

Toupet Fundoplication is a 270° partial wrap of the upper stomach around the back of the lower oesophagus, performed laparoscopically. It is an effective alternative to the standard 360° Nissen wrap, particularly for patients with weak oesophageal motility, where a full wrap may cause swallowing difficulties. The Toupet wrap provides excellent control of acid reflux while reducing the risk of side effects such as bloating and gas-bloat syndrome. Dr. Tejasree Vengala performs laparoscopic Toupet fundoplication at Lux Hospitals, Hyderabad, in carefully selected patients.

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How the Procedure Works

Anaesthesia & Preparation

Surgery is performed under general anaesthesia. The abdomen is prepared and draped, and a urinary catheter is placed.

Port Placement

Four to five small incisions of 5–10 mm are made in the upper abdomen for the camera and working instruments.

Hiatus Mobilisation

Any hiatus hernia is reduced, and the lower oesophagus is mobilised carefully. The diaphragmatic crura are repaired.

270° Posterior Wrap

The upper part of the stomach is wrapped 270° around the back of the lower oesophagus and secured with sutures, creating a partial wrap.

Closure & Recovery

The small incisions are closed with absorbable sutures. Patients start liquids the same evening and are discharged in 1–2 days.

Outcomes

90–120 minDURATION

1–2 DaysHOSPITAL STAY

>85%SYMPTOM RELIEF

3–4 WeeksFULL RECOVERY

Who Needs This Treatment?

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Effective control of acid reflux
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Lower risk of post-operative swallowing difficulties
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Better tolerated in patients with weak oesophageal motility
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Patients can usually belch and vomit if needed
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Combined with hiatus hernia repair in the same sitting
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Keyhole technique with quick recovery

Choosing between Nissen and Toupet is rarely a yes-or-no decision — it is a careful matching of the wrap to the patient. A weaker oesophagus benefits from a partial wrap, and the result is a patient who controls reflux without struggling to swallow.

— — Dr. Tejasree Vengala, Consultant Proctologist & Laparoscopic Surgeon, Lux Hospitals, Hyderabad

Common Questions

Frequently Asked Questions

How is Toupet different from Nissen?+

When is Toupet preferred?+

Will I be able to stop acid medications?+

Are there any long-term restrictions?+

Not sure which treatment is right for you?

Book a consultation with Dr. Tejasree Vengala and get a personalised treatment plan.

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