Gastropexia

Gastropexy according to Nissen was first described by R. Nissen in 1956, posterior gastropexy according to Hill in 1967 by L. D. Hill, and the anterior form according to Boerema by W. J. Boerema in 1969 (Nachtigäller 2003).

In Germany, a system for the placement of a PEG as an endoscopically controlled direct puncture procedure with double gastropexy was introduced for the first time in 1999 (Stein 2003).

Gastropexy is a surgical reduction and fixation of the stomach by T-anchor or suture procedures in the area of the anterior abdominal wall (Herold 2022 / Denzer 2015).

It is used in the context of hiatal hernia (Herold 2022), gastroesophageal reflux disease (Fuchs 1997), chronic gastric volvulus in infancy (Schleef 2003), percutaneous endoscopic gastrostomy (Schuhmacher 2021), etc.

One differentiates between different forms of gastropexy:

- posterior gastropexy according to Hill (Fuchs 1997): Here the gastric wall folds are fixed to the preaortic membrane in the course of a valvuloplasty (Siewert 1981). However, the success of this surgical procedure was limited because it led to many recurrences (Fuchs 1997).

- Anterior gastropexy according to Boerema (Fuchs 1997): In this procedure, the small curvature is attached to the anterior abdominal wall for fixation of the stomach. The cardia and possibly part of the abdominal esophagus are subsequently fixed to the lateral abdominal wall (Blum 1981).

- Gastropexy according to Nissen: In this procedure, the large gastric curvature is fixed to the anterior abdominal wall first, followed by the small curvature to the parietal peritoneum (Blum 1981).

Bittner (2018) recommends anterior gastropexy in addition to fundoplication as an additional measure to reduce the recurrence rate.

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