Fundoplication (treatment of reflux)

Fundoplication, commonly known as reflux surgery, is a surgical procedure used to correct problems of the lower esophageal sphincter (LES) associated with gastroesophageal reflux disease (GERD). It may also be used on patients with esophagitis or to repair a hiatal hernia. This procedure prevents acid from traveling back into the esophagus by strengthening the valve between the esophagus and stomach.

During fundoplication, the fundus (the upper part of the stomach) is wrapped around a band of muscles at the base of the esophagus and sewn into place. This helps strengthen the LES muscles and increases pressure on them, preventing reflux from occurring. The LES muscles are supposed to open when food is present in the esophagus, in order to let it into the stomach, but is supposed to close once the food has entered, serving as a one-way valve. In many people, the valve is not strong enough to stay closed and acid may flow back into the esophagus, causing irritation and inflammation of the lining.

Candidates

Fundoplication is most often performed on patients who have complications from GERD or esophagitis such as a narrowing of the esophagus or precancerous indications. It may also be performed on patients with severe symptoms such as difficulty breathing or pneumonia. Fundoplication is considered an alternative to GERD medications for people who do not respond to or cannot tolerate these medications.

This procedure is not recommended for older patients or for those with existing health problems, bloating or impaired digestion, as fundoplication can worsen these conditions.

Procedure

Fundoplication is performed under general anesthesia in an in-patient setting. It can be performed through an open procedure or laparoscopically, depending upon the severity of the condition and overall health of the patient. If it is an open procedure, the doctor will make an incision several inches long in the middle of the abdomen. He or she will then wrap the fundus in a circle around the lower part of the esophagus and keep it in place with stitches.

The technique is similar for a laparoscopic procedure, except that several small incisions (about one centimeter in length) are made in the abdomen area instead. The whole procedure takes about two hours to complete.

Recovery

Laparoscopic treatment only requires a short hospital stay, with most patients able to return to work and other normal activities within two to three weeks. Recovery time after an open procedure may take four to six weeks before patients can return to work.

Results

Most patients see significant improvement in their GERD symptoms after fundoplication. Patients are less likely to need medication after surgery and are overall satisfied with their outcome. While these results are successful, symptoms may return after some time, as there are no studies to show the long-term effects of this procedure.

Risks

As with any type of surgical procedure, there are certain risks involved with fundoplication. Some of these risks include infection, bleeding, reactions to anesthesia, and others. Some patients develop additional symptoms after surgery, which may include difficulty swallowing, excessive gas, gas buildup from an inability to burp, and bloating and discomfort. Patients can minimize these risks by choosing an experienced surgeon and by adhering to instructions for before and after surgery.

Surgery for GERD is not always necessary, but may be recommended for severe cases. A successful procedure can help eliminate the need for daily medication. It is important to weigh the benefits of several treatment options before making a decision. You can learn more about this procedure by calling us for an appointment today.

To learn more about our Fundoplication (treatment of reflux) Services, please contact us at (516) 627-5262 today to schedule an appointment.