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Nissen Fundoplication (Treatment of GERD)
Laparoscopic Nissen Fundoplication (Treatment of GERD)
Gastroesophageal reflux disease (GERD) is a digestive disorder that is caused by gastric acid flowing from the stomach into the esophagus.
Heartburn, also called acid indigestion, is the most common symptom of GERD.
Treatment can include lifestyle changes, such as weight reduction, avoiding certain types of food and taking medications to alleviate symptoms. Surgery may be an option when treatment with medications does not completely relieve symptoms. It's also a good option for patients whose symptoms are well controlled but who don't want to take medication, and for patients with complications of reflux disease, such as ulcers, strictures or Barrett's esophagus.
During the fundoplication surgery, the surgeon improves the natural barrier between the stomach and the esophagus by wrapping a part of the stomach known as the gastric fundus around the lower esophagus. This prevents the flow of acids from the stomach into the esophagus, and strengthens the valve between the esophagus and stomach, which stops acid from backing up into the esophagus as easily. This procedure is often done using a laparoscopic surgical technique. It can also be done as traditional (open) surgery.
A laparoscopic surgical procedure is an alternative to traditional or what is known as "open" surgery, in which a large incision must be made. Surgeons provide patients with a technologically advanced option. Now, minimally invasive surgery is used to treat GERD. Our surgeons use laparoscopic surgery to make incisions only millimeters in size. Laparoscopic surgery eliminates the need for a long incision. Small incisions are made to accommodate small tubes called "trocars." These create a passageway for special surgical instruments and a laparoscope.
Laparoscopic surgery has many advantages over traditional surgery. Less scarring and recovery time are two of the most compelling advantages of this procedure. Hospital stays are reduced and total recovery time is cut in half. The risk of infection is also lower because of the smaller incisions.
Surgical candidates are those whose heartburn is not well controlled with medicine, those who want to fix the problem without having to take medicine long term, and those who are having complications from reflux, including ulcers, strictures, hernias or Barrett's esophagus.
Patients are counseled before the operation about lifestyle and dietary adjustments that are needed for about six weeks following surgery. They are advised to eat smaller amounts of food at each meal, to chew their food well, and avoid chewing gum and drinking carbonated beverages, to make sure the surgery will heal properly.
The laparoscopic surgery often requires a hospital stay of only 23 hours. You should be able to return to normal activities between one and two weeks, compared with four to six weeks for traditional surgery.
The success rate for the minimally invasive surgery is 90 to 95 percent for patients who have the typical symptoms of GERD, such as heartburn, regurgitation, or belching. For those whose with less typical symptoms, including hoarseness and chronic cough, the surgery is about 70 to 80 percent effective at relieving their symptoms.
Be sure to call your physician or surgeon if you develop any of the following: