Gastroesophageal reflux or esophageal reflux occurs when the esophageal muscles do not close the cardiac opening of the stomach (the opening from the esophagus into the stomach) tightly, causing reflux where the contents of the stomach back to the esophagus.
-The fundoplication involves wrapping the fundus of the stomach around the lower part of the esophagus to tighten the cardiac opening of the stomach.
-Anti-reflux surgery is also known as Nissen fundoplication.
-Reflux can cause heartburn, vomiting, coughing, and wheezing.
-Fundoplication can reduce or prevent reflux completely, so it may be an option for you if medications and lifestyle changes don’t improve the esophageal reflux.
Why do we do fundoplication for the treatment of GERD?
Your doctor may recommend anti-acid reflux surgery as fundoplication to treat gastroesophageal reflux disease that affects the esophageal mucosa.
-Gastroesophageal reflux disease is characterized by a feeling of chronic burning sensation, vomiting, and cough. Anti-acid reflux surgery also treats the hiatal hernia, a condition in which part of the stomach is pushed up through an opening in the diaphragm.
-Your doctor will consider surgery as fundoplication to treat reflux esophagus is an effective solution if other treatment options that have lower risks for complications are ineffective, such as medications.
-Ask your doctor about all treatment options you have and take another opinion before deciding surgery as a fundoplication as a treatment option.
How fundoplication is performed to treat GERD?
Fundoplication will be done in the hospital. The surgeon will make a large incision or a series of small incisions on the upper part of your abdomen. From this opening, the funds of the stomach is wrapped and fixed around the lower esophagus by stitches.
-This tightens and strengthens the cardiac opening of the esophagus and prevents stomach contents from retreating into the esophagus.
-The surgeon performs anti-reflux surgery using one of the following methods:
1/Laparoscopic: This is surgery based on minimal surgical intervention, which includes the introduction of special tools and a laparoscope through three or four small incisions in the upper abdomen.
-A laparoscope is a thin, lighted instrument with a small camera. The camera sends images from inside your body to a video screen that the surgeon sees during surgery.
-Another option for surgery is by an endoscope through the mouth to the esophagus, where the surgeon sees your stomach on the video screen while tightening the end of the esophagus with stitches.
-Laparoscopic surgery generally involves the quickest recovery and less pain than open surgery.
-This is because it relies on minimal surgical intervention and causes less trauma to the tissues and organs, where the surgeon makes small incisions or does not make any incisions at all, instead of the larger incision used in open surgery.
2/open surgery: open surgery involves making a larger incision in the upper abdomen, and an open surgery incision allows your doctor to see your stomach and reach it directly.
-Open surgery generally involves longer recovery and more pain than laparoscopic surgery.
-Because open surgery requires a larger incision and more cutting and opening of muscles and other tissues more than laparoscopic surgery.
-However, open surgery may be a safer or more effective method for some patients.
-Surgeons sometimes combine laparoscopic surgery with open surgery. Sometimes, after laparoscopic surgery begins, they decide that open surgery is needed to complete the surgery safely and effectively.
-The surgeon will advise you on which procedure is best for you and how long you need to stay in the hospital-based on:
-Perhaps you may choose any surgery you prefer, but you should be aware of the various surgical procedures for esophageal reflux and know why the surgeon uses a special type in your case.
Recover after fundoplication
Knowing the expected results from the procedure can help you and make your way to recovery after the surgery easier.
-You will stay briefly in the recovery room after surgery until you are alert, breathing effectively, and your vital signs are stable.
-You may have a tube in your mouth or nose to reach your stomach. This tube releases air and drains fluid from your stomach so that your body can process these materials on its own.
-You may have a sore throat if a tube is placed in the trachea during surgery. This is usually temporary but tell the health care team if you are uncomfortable.