Laparoscopic Nissen Fundoplication

What is heartburn?

Heartburn, also called gastroesophageal reflux or GERD, is a condition where the acids in the stomach back up into the esophagus. The esophagus is the tube that carries food from the back of your mouth to your stomach. At the lower end of the esophagus there is a small ring of muscle that acts as a one-way valve. When there is a problem with the value, stomach contents can back-up or "reflux" into the esophagus. Because stomach contents are acidic in nature, this reflux causes a burning sensation.

What are some treatment options for GERD?

Making changes in your life style, taking medicines and surgery are the treatments for GERD. Lifestyle changes that improve GERD include weight loss, smoking cessation, reduced alcohol intake, and dietary changes such as a low fat, low caffeine diet. Medications that are used to treat GERD include over-the-counter antacids and medicines such as NexiumTM, Prevacid® and Protonix®. Surgery becomes an option when the medicines fail to work or become intolerable due to side effects.

What is a laparoscopic fundoplication?

The surgery strengthens the "valve" between the stomach and the esophagus. This is achieved by wrapping the upper part of the stomach or fundus) around the lower esophageal sphincter. This surgical procedure is called a fundoplication. A fundoplication can be performed as an open procedure or as a laparoscopic surgery. A laparoscopic fundoplication means that a surgeon will perform the operation with the use several small incisions, special instruments, and a videoscope and TV monitors.

What are the advantages of having this type of surgery?

Laparoscopic fundoplication requires a shorter hospital stay, less pain, and leaves less noticeable scars in comparison to the traditional surgery.

What are the risks?

Possible risks are infection and injury to nearby organs. The risks are minimized as compared to traditional surgery as smaller incisions are used.

Will I need any tests before surgery?

Your doctor may order an upper endoscopy, 24-hour pH monitoring, and an esophageal motility study.

How should I prepare for surgery?

The night before your surgery, do not eat or drink anything after midnight. The morning of your surgery, do not smoke, chew tobacco or gum. You will be contacted as to what time to arrive at the hospital on the day of surgery. Bring any comfort items from home that you may need for a brief hospital stay.

What should I expect after surgery?

The usual hospital stay is usually three to five days. Some patients may need to stay longer. You will be given medications to help prevent hiccups and nausea. You will be on a clear liquid diet and advanced gradually to solid foods. Sit upright when you eat and remain upright for at least 20 minutes after eating. The dietician will talk to you about the best diet for you. Most people return to their normal level of activity in about two to three weeks.