CPT® Code 43325

Esophagogastric fundoplasty, specifically the Thal-Nissen procedure, is a surgical intervention designed to address complications arising from a hiatal hernia and gastroesophageal reflux disease (GERD). This procedure aims to restore the normal anatomical position of the stomach and esophagus, thereby alleviating symptoms associated with reflux. The term "fundoplasty" refers to the surgical technique that involves the manipulation of the fundus, which is the upper part of the stomach, to create a barrier against the backflow of gastric contents into the esophagus. The procedure is performed using a transpleural approach, which involves accessing the esophagus through the pleural cavity, allowing for better visualization and mobilization of the esophagus and surrounding structures. The surgical steps include making incisions in the diaphragm and stomach, mobilizing the greater curvature of the stomach, and utilizing a split thickness skin graft to reinforce the fundus. The ultimate goal of the Thal-Nissen procedure is to create a functional valve mechanism at the esophagogastric junction, thereby reducing the incidence of reflux and improving the patient's quality of life.