You may be sore and have some pain in your belly for several weeks after surgery. If you had laparoscopic surgery, you also may have pain near your shoulder for a day or two after surgery. It may be hard for you to swallow for up to 6 weeks after the surgery.
There is usually minimal pain associated with this operation. The abdomen will be sore as well as the small incision sites, and some patients have shoulder pain for the first day or two. The shoulder pain is caused by gas left in your abdomen during the operation. It will disappear on its own.
Expect stay in the hospital one to two days after this procedure. On the morning after your procedure you will get a swallowing study to make sure everything is in the proper place. After that, you will start on a liquid diet.
During a Nissen fundoplication
The procedure normally takes about 1 hour to 1 hour 30 minutes. The surgeon makes 4 to 5 small cuts in your tummy (abdomen). They insert instruments through these cuts to do the surgery.
A laparoscopic fundoplication surgery to treat GERD or hiatal hernia is still major surgery and the patient and surgeon should think of it in that light.
Nissen fundoplication not only relieves symptoms of acid reflux, but it can also help prevent future complications—even for patients whose acid reflux symptoms are mostly well managed by medications. Oftentimes, these patients are unaware of the long-term effects of GERD.
How quickly you recover depends on which type of surgery you had. After laparoscopic surgery, most people can go back to work or their normal routine in about 2 to 3 weeks, depending on their work. After open surgery, you may need 4 to 6 weeks to get back to your normal routine.
The capacity of the stomach is decreased slightly and it doesn't distend as much until healing occurs. On average, our patients lose approximately 10% of their weight. For this reason, it is extremely important for patients to understand their protein and caloric needs following surgery.
You should be able to progress to a soft-normal diet 4 – 6 weeks after surgery. What is a soft-normal diet? A soft-normal diet involves gradually introducing more solid textures to your diet. While you are having a soft-normal diet you should avoid the same foods you were advised to avoid on page 4.
Nissen fundoplication
Although this works well to control reflux, it can also cause complications such as bloating and swallowing difficulties, called dysphagia. In some people, these complications persist after surgery.
I have found that most of my patients have excellent control of their GERD symptoms with a fundoplication wrap that still allows the majority of them to belch and vomit.
This is the name given to the most common operation to stop reflux. The operation helps to prevent vomiting and reflux by “wrapping” the top part of the stomach around the bottom part of the oesophagus. This tightens the oesophagus and prevents backflow of food and stomach acid.
Avoid any foods that cause stomach gas and distention. These foods include corn, dried beans, peas, lentils, onions, broccoli, cauliflower and any food from the cabbage family. Avoid carbonated drinks, alcohol, citrus and tomato products.
However, it is major surgery and it has its own risks associated with it.
This is because your stomach is slightly smaller. Eating or drinking too much at once can cause discomfort. This should slowly get better over about 6 to 8 weeks.
Nissen procedure is associated with some weight loss but not enough when compared to gastric sleeve surgery or gastric bypass procedure.
Shortness of breath may result from a slipped Nissen fundoplication, aka recurrent hiatal hernia. Shortness of breath may be precipitated by a heavy meal or gas accumulation in stomach.
Transient dysphagia occurs in 40% to 70% of patients after Nissen fundoplication. This is thought to be secondary to edema at the gastroesophageal junction (GEJ) or transient esophageal hypomotility. Fortunately, dysphagia usually resolves spontaneously within 2 to 3 months.
Postoperative weight gain may lead to fundoplication failure to contain reflux due to the increase in intra-abdominal pressure and modification of the gastroesophageal pressure gradient 14 , 23 . In this case, a new surgery may be necessary to control weight and preserve the anti-reflux mechanism.
Laparoscopic fundoplication (LF) is the standard surgical procedure for the treatment of gastro-oesophageal reflux disease (GORD). Laparoscopic Roux-en-Y gastric bypass (LRYGB) is commonly performed to achieve weight loss in obese patients, but it also has anti-reflux properties.
Side effects of Nissen fundoplication such as dysphagia, increased bloating and flatulence, and inability to belch or vomit may limit the success of antireflux surgery[12,13].
Dumping syndrome may occur when a large volume of gastric content is delivered to the duodenum or jejunum, resulting in both gastrointestinal and vasomotor symptoms. Occasionally, dumping syndrome may be a complication in patients that have undergone nissen Fundoplication, especially in adults.
The cramping and bloating usually go away in 2 to 3 months, but you may continue to pass more gas for a long time. Because the surgery makes your stomach a little smaller, you may get full more quickly when you eat. In 2 to 3 months, the stomach adjusts. You will be able to eat your usual amounts of food.
There is usually minimal pain associated with this operation. The abdomen will be sore as well as the small incision sites, and some patients have shoulder pain for the first day or two. The shoulder pain is caused by gas left in your abdomen during the operation. It will disappear on its own.
The most common complications are difficulty swallowing, abdominal bloating, diarrhea, and nausea. Most patients can't belch as well as they could before surgery, although the inability to belch is distinctly uncommon. About 25% of patients can't vomit after surgery.