Anti-Reflux Surgery (Fundoplication)

Anti-Reflux Surgery (Fundoplication)

Fundoplication is a highly effective surgery for treating reflux-related symptoms, GERD and hiatal hernias. Several types of laparoscopic fundoplication procedures are available such as Nissen 360-degree wrap, Toupet 270-degree posterior wrap, Watson anterior 180-degree wrap, etc. 

How is Anti-Reflux Surgery (Fundoplication) done?

The steps of the fundoplication procedure may vary according to the procedure.

  • The Doctor puts intravenous (IV) tubes into the patient’s veins for fluid regulation and administering anaesthesia.
  • Small cuts are made through the skin, and peritoneum (layer of tissue around the gut).
  • A thin, lighted tube with a camera and tiny surgical tools are inserted.
  • The patient’s fundus is wrapped around the tissue from the lower esophagus.
  • To attach the fundus to patient’s esophagus, dissolvable stitches are used.
  • Any gas, if present in the abdomen is vented out.
  • All tools are removed and cuts are closed with dissolvable stitches.
  • The overall duration of the procedure is 2-4 hours.

After the Surgery 

  • The patient is discharged after 3-4 days or a week in case of an open surgery
  • Surgical dressings over the incisions are provided to stop bleeding and drainage for 02-07 days 
  • Patient may need to be given food through a gastrostomy tube for a few weeks or permanently
  • Painkillers are prescribed for pain management
  • In most cases dissolvable stitches under the skin that might not require removal. 
  • Incisions can be cleaned with warm, clean water and a gentle soap
  • 2 weeks post surgery, the patient might be recommended to eat soft or liquid foods, 3 to 4 weeks after surgery, slowly a patient might include solid — yet still softened — foods. 1- 3 months post surgery and beyond, the patient would  be able to gradually return to the normal diet. But might require avoiding eating foods that can get stuck in the esophagus such as chicken, or nuts, etc
  • Follow up appointments with the doctor need to be kept

Important Information

  1. In case redness, skin irritation is experienced or pus leakage from the incision area, after the Surgery, consult a Doctor immediately
  2. Some complications of fundoplication include:
    • piercing of the lining or walls in esophagus, stomach, or tissues around the lungs likely during laparoscopy
    • infection or break open of stitches and exposure of  the surgical area
    • lung infections or trouble swallowing
    • dumping syndrome (food travels too fast from stomach to intestines), gagging and nausea
    • gas buildup, inability to throw up
    • reflux continuity 
    • need for follow-up surgery
  1. Following tips help minimize chances of any long-term issues or need for another surgery:

    • Avoid foods that can worsen the symptoms
    • Eat smaller proportions
    • Raise the head and upper body while sleeping 
    • Limit or avoid intake of alcohol and caffeine 
    • Quit smoking
    • Exercise 20-30 minutes every day 

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