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NCT Number: NCT07718828

Laparoscopic Nissen Versus Toupet Fundoplication for Hiatal Hernia.

This randomized controlled trial compares laparoscopic Nissen fundoplication and laparoscopic Toupet fundoplication in patients undergoing surgical treatment for hiatal hernia associated with gastroesophageal reflux disease. Participants will be randomly assigned to one of two surgical groups. The study will evaluate postoperative pain, health-related quality of life, hospital stay, recurrence of reflux symptoms, gas-bloat symptoms, operative time, fundoplication time, and postoperative complications.

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Key information

Age range

18 year–90 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

UMHAT Sofiamed

Sofia, Sofia-Grad, 1517, Bulgaria

Location status: Recruiting

Location contact

Alexander I Tsvetanov

SUB_INVESTIGATOR

Katya T Todorova

PRINCIPAL_INVESTIGATOR

Katya T. Todorova, PhD

CONTACT

[email protected]

0884744833

Teodor D Atanasov, Assoc. prof.

PRINCIPAL_INVESTIGATOR

CONTACT

[email protected]

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Patients aged 18 to 90 years
  • Patients diagnosed with primary hiatal hernia by fibrogastroscopy and/or barium swallow examination
  • Patients with symptoms of gastroesophageal reflux disease
  • Patients scheduled for elective laparoscopic hiatal hernia repair with fundoplication
  • Patients able to provide informed consent

Exclusion criteria

Patients younger than 18 years or older than 90 years Patients with recurrent hiatal hernia Patients who are not suitable for general anesthesia Patients who prefer a surgical approach other than laparoscopic surgery Patients who are unable or unwilling to provide informed consent

Treatment and study plan

Laparoscopic Nissen fundoplication

Procedure

The procedure includes a complete 360° fundoplication performed as part of standard laparoscopic antireflux surgery.

Laparoscopic Toupet fundoplication

Procedure

The procedure includes a partial posterior 270° fundoplication performed as part of standard laparoscopic antireflux surgery.

Primary outcomes

  1. Postoperative pain score at 24 hours

    Time frame: 24 hours after surgery

    Postoperative pain will be assessed 24 hours after surgery using the Visual Analog Scale. The score will be used to compare early postoperative pain between participants undergoing laparoscopic Nissen fundoplication and those undergoing laparoscopic Toupet fundoplication.

  2. Postoperative Pain Score at 7 Days

    Time frame: 7 days after surgery

    Postoperative pain will be assessed 7 days after surgery using the Visual Analog Scale. The score will be used to evaluate and compare short-term postoperative pain between the two intervention groups.

  3. Change in Health-Related Quality of Life After Surgery

    Time frame: Preoperatively, 1 week, 4 weeks

    Health-related quality of life will be assessed using the GERD-Health Related Quality of Life questionnaire. Preoperative scores will be compared with postoperative scores in order to evaluate changes in reflux-related symptoms and quality of life after laparoscopic Nissen or Toupet fundoplication.

  4. Postoperative Hospital Stay

    Time frame: From the day of surgery until hospital discharge - up to 30days

    Postoperative hospital stay will be measured as the number of days from the day of surgery until hospital discharge. The duration of hospital stay will be compared between the Nissen and Toupet fundoplication groups.

  5. Recurrence of Gastroesophageal Reflux Symptoms

    Time frame: 4 weeks and 1 year after surgery

    Recurrence of gastroesophageal reflux symptoms will be assessed during postoperative follow-up. The presence or absence of recurrent reflux symptoms will be recorded and compared between the two intervention groups.

Secondary outcomes

  1. Operative Timе

    Time frame: Intraoperative

    Operative time will be measured in minutes from the beginning to the end of the laparoscopic surgical procedure. Total operative time will be compared between participants undergoing Nissen fundoplication and those undergoing Toupet fundoplication.

  2. Fundoplication Time

    Time frame: Intraoperative

    Fundoplication time will be measured in minutes as the time required to perform the fundoplication component of the procedure. This measure will be used to compare the technical duration of Nissen and Toupet fundoplication.

  3. Gas-Bloat Symptoms

    Time frame: 3 days; 1 week

    Postoperative gas-bloat symptoms will be assessed during follow-up. The presence or absence of symptoms such as bloating, inability to belch, or increased abdominal gas-related discomfort will be recorded and compared between the two groups.

  4. Postoperative Complications

    Time frame: Up to 30 days after surgery

    Postoperative complications will be recorded according to type and frequency. The number and nature of postoperative complications will be compared between the Nissen and Toupet fundoplication groups.

Study contacts

Contact information is provided by the study sponsor or research team.

Katya T. Todorova, PhD

CONTACT

[email protected]

+359884744833

Teodor D. Atanasov, Assoc. Prof.

CONTACT

[email protected]

+359899802612

Sponsors and collaborators

Lead sponsor

Sofia Med Hospital

Other

Registry information

Official study title

Laparoscopic Nissen Versus Toupet Fundoplication for Gastroesophageal Reflux Management in Patients With Hiatal Hernia: A Patient- and Assessor-Blinded Randomized Controlled Trial

Important dates

Study start
2023
Primary completion
2026
Study completion
2027
First posted
Jul 22, 2026
Registry last updated
Jul 22, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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