Certified Neuroscience Registered Nurse (CNRN) Practice Exam

What is the surgical procedure that wraps the fundus of the stomach around the lower esophageal sphincter for a sliding hiatal hernia?

1. Pantoloc surgery

2. Nissen fundoplication

3. Roux-en-Y surgery

4. Laparoscopic cholecystectomy

The correct answer is: Nissen fundoplication

Nissen fundoplication is a surgical procedure commonly employed to address issues related to the lower esophageal sphincter (LES), particularly in cases of a sliding hiatal hernia. This procedure involves wrapping the top portion of the stomach, called the fundus, around the lower esophagus. The purpose of this wrap is to reinforce the LES, preventing the backflow of stomach contents into the esophagus, which can lead to symptoms such as reflux or heartburn. This procedure effectively lowers the incidence of gastroesophageal reflux disease (GERD) associated with hiatal hernias by creating a mechanical barrier that helps keep the stomach contents in place and reduces the likelihood of esophageal irritation. It also addresses the anatomical changes that occur with a sliding hiatal hernia, where a portion of the stomach ascends through the diaphragm into the thoracic cavity. In contrast, the other options do not pertain to this specific procedure or its indication. Pantoloc surgery is not a defined surgical term associated with a specific procedure, Roux-en-Y surgery is primarily a type of bariatric surgery or gastrointestinal bypass procedure, and laparoscopic cholecystectomy is a surgery to remove the gallbladder. Thus, Nissen fundoplication is the