Fundoplication Surgery

Fundoplication is the standard surgical treatment for GERD. The purpose of the surgery is to reduce heartburn caused by acid reflux.

During the surgery, the upper part of the stomach (fundus) is gathered, wrapped and sutured (sewn) around the lower part of the esophagus. This allows the lower part of the esophagus to pass through a small tunnel made from the stomach muscle. This will help prevent acid reflux, and strengthen the valve between the esophagus and stomach, which stops acid from backing up into the esophagus as easily.

When is fundoplication performed?

The doctor may recommend fundoplication when a patient has one of the following symptoms:

• Severe heartburn / acid reflux

• Severe inflammation of the esophagus that has been caused by the backflow of stomach contents (erosive esophagitis)

• There is a narrowing of the esophagus because its been damaged by acid reflux (esophageal stricture)

• A hiatal hernia where the upper part of the stomach slides up through the opening in the diaphragm and doesn't drop back down (para-esophageal hernia)

• Chronic inflammation in the lungs, such as pneumonia, caused by inhaling gastric fluids that have backed up into the throat

What are the types of fundoplication surgery?

• Laparoscopic fundoplication is most often performed. This surgery involves using a lighted tube that is inserted through a small incision in the abdomen. Recovery time is only a few days in the hospital.

• A procedure called "Open" fundoplication requires a larger incision in the abdomen or the chest. The recovery time for this procedure is longer than that for the laparoscopic surgery, requiring a week or longer stay in the hospital.

What a patient can expect after fundoplication surgery

• During surgery, a nasogastric tube (NG tube) is placed in the stomach through the nose and throat. Some surgeons leave this tube in for a few days after surgery, while other surgeons choose not to.

• There is typically a one- to three-day hospital stay after a laparoscopic surgery, and a two- to six-day recovery with the "open" procedure.

• Eating small, frequent meals while avoiding foods that trigger heartburn are important both during recovery and afterwards. Foods to avoid include:
  • Fried foods
  • Fatty foods
  • Citrus fruits
  • Tomato products
  • Caffeine
  • Alcoholic beverages
  • Citrus fruit drinks
  • Chocolate
  • Peppermint
  • Pepper

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_{Sources:
"Heartburn Or Gastroesophageal Reflux Disease (GERD)." American College of Gastroenterology. 13 Feb 2007.}

"Heartburn, Hiatal Hernia, and Gastroesophageal Reflux Disease (GERD)." NIH Publication No. 03–0882 June 2003. National Digestive Diseases Information Clearinghouse (NDDIC). 13 Feb 2007.