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There are two main variations: the Nissen fundoplication, in which a portion of the stomach is wrapped completely around the esophagus, and the Toupet fundoplication, in which a portion of the stomach is wrapped partway around the esophagus. Both procedures are effective.
Fundoplication is the gold standard of GERD surgeries. During the procedure, the surgeon uses the upper part of the stomach to reinforce and tighten the lower esophagus and strengthen the sphincter, which is the bundle of muscles that helps prevent the contents of the stomach from moving back up the esophagus.
You might have bleeding, an infection, breathing problems, bloating, or pain when you swallow. Call your doctor for any symptoms that bother you or don't go away. Expect to stay in the hospital for about 4 to 6 days, and then spend a month to 6 weeks recovering at home with the open surgical procedure.
GERD is considered a chronic disease and may not be entirely curable. Working with your doctor on a treatment plan that aligns with your stage of GERD will help manage your symptoms and halt the progression of the condition.
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.
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.
Candidates for reflux surgery
You may be a good candidate for surgery when: PPIs fail to relieve your acid reflux. You have a hiatal hernia. You have esophagitis.
Side effects of anti-reflux surgery are related to the creation of a valve at the lower esophageal sphincter where none previously existed. These may include: Difficult, painful swallowing that may last up to three months, but is usually gone in 4 to 6 weeks. It may be associated with pain in the shoulder as well.
The newest therapy is the transoral incisionless fundoplication (TIF). This is an incisionless fundoplication performed with an endoscope that is inserted through the mouth and into the stomach. Short-term results appear favorable in carefully selected patients; however, long-term studies have not yet been completed.
Nissen fundoplication, gastric sleeve surgery and Rous en Y gastric bypass all have the gastric fundus in common. Whether the gastric fundus is wrapped, excised or bypassed the end result is the same: weight loss, decreased meal size, early satiety, and lower Ghrelin levels. In addition, there is decreased acid reflux.
Expect to stay in the hospital for about 4 to 6 days, and then spend a month to 6 weeks recovering at home with the open surgical procedure.
Mortality from antireflux surgery, including fundoplication and gastric and esophageal resection, remained stable at 1.9/1,000 operations.
A study finds that up to five years after surgery, many patients still have symptoms -- yet nearly all felt their surgery was working well. Daily heartburn is medically known as gastroesophageal reflux disease, or GERD, and though excess acid can be tamed through lifelong medication, many people opt for surgery.
The primary risk of Nissen fundoplication surgery is that symptom relief does not always last. Some patients need another surgery after two to three years. Like all surgeries, Nissen fundoplication also carries a risk of infection at the incision site.
Just as other body parts, the fundoplication wrap created during the GERD surgery will slowly loosen over time. Therefore even some patients that originally could not burp or vomit will be able to do so as the wrap loosens.
Surgery is a last resort after all treatments and medications have not relieved your symptoms. If you have made lifestyle changes, altered your diet appropriately, and still are suffering with gastroesophageal reflux disease, GI Solutions may recommend surgery for you.
You will have general anesthesia for the surgery so you are not awake and do not feel any discomfort. The operation might last several hours. After that, you go to the recovery room until you wake up completely. You will probably stay in the hospital at least one night, and you might need to stay longer.
As a result of changes caused by these operations, most patients will experience some weight loss. 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.
You can expect to go home 1 to 3 days after Nissen fundoplication surgery. If you have open surgery, you might need to stay in hospital for longer.
In some people the burning sensation calms down after just a few minutes, but that is not a rule, and it can last up to a few days in some other cases. However, if heartburn lasts even longer and if it occurs even more frequently, we recommend that you see your doctor as soon as possible.