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Reflux Surgery

 

OVERVIEW

Although “heartburn” is often used to describe a variety of digestive problems, in medical terms, it is actually a symptom of gastroesophageal reflux disease (GERD). In this condition, stomach acids reflux or “back up” from the stomach into the esophagus. Heartburn is described as a harsh, burning sensation in the area in between your ribs or just below your neck. The feeling may radiate through the chest and into the throat and neck. Many adults in the United States experience this uncomfortable, burning sensation at least once a month. Other symptoms may also include vomiting, difficulty swallowing and chronic coughing or wheezing.

Patients who do not respond well to lifestyle changes or medications or those who continually require medications to control their symptoms, will either have to learn to live with their condition, or, if found to be a candidate* undergo a surgical procedure that is very effective in treating GERD, Laparoscopic Anti-Reflux Surgery.

Laparoscopic anti-reflux surgery (commonly referred to as Laparoscopic Nissen Fundoplication) involves reinforcing the “valve” between the esophagus and the stomach by wrapping the upper portion of the stomach around the lowest portion of the esophagus – much the way a bun wraps around a hot dog.

In a laparoscopic procedure, surgeons use small incisions (1/4 to 1/2 inch) to enter the abdomen through cannulas (narrow tube-like instruments). The laparoscope, which is connected to a tiny video camera, is inserted through the small incision, giving the surgeon a magnified view of the patient’s internal organs on a television screen.

The entire operation is performed “inside” after the abdomen is expanded by inflating gas into it.

Although laparoscopic anti-reflux surgery has many benefits, it may not be appropriate for some patients. Obtain a thorough medical evaluation by a surgeon qualified in laparoscopic anti-reflux surgery in consultation with your primary care physician or Gastroenterologist to find out if the technique is appropriate for you.


HOW TO PREPARE

Preoperative preparation includes blood work, medical evaluation, chest x-ray and an EKG depending on your age and medical condition. Your surgeon may request that you completely empty your colon and cleanse your intestines prior to surgery. You may be requested to drink clear liquids, only, for one or several days prior to surgery.

  • After midnight the night before the operation, you should not eat or drink anything except medications that your surgeon has told you are permissible to take with a sip of water the morning of surgery.
  • Drugs such as aspirin, blood thinners, anti-inflammatory medications (arthritis medications) and Vitamin E will need to be stopped temporarily for several days to a week prior to surgery.
  • Quit smoking and arrange for any help you may need at home.

RESULTS

Studies have shown that the vast majority of patients who undergo the procedure are either symptom-free or have significant improvement in their GERD symptoms.


 

WHAT TO EXPECT

After the operation, it is important to follow your doctor’s instructions. Although many people feel better in a few days, remember that your body needs time to heal. You are encouraged to be out of bed the day after surgery and to walk. This will help diminish the soreness in your muscles.

You will probably be able to get back to most of your normal activities in one to two weeks’ time. These activities include showering, driving, walking up stairs, working and engaging in sexual intercourse.


RISKS

Although the operation is considered safe, complications may occur as they may occur with any operation. Complications may include but are not limited to:

  • Adverse reaction to general anesthesia
  • Bleeding
  • Injury to the esophagus, spleen, stomach or internal organs
  • Infection of the wound, abdomen, or blood
  • Other less common complications may also occur, and your surgeon may wish to discuss these with you

Be sure to call your physician or surgeon if you develop any of the following:

  • Persistent fever over 101 degrees F (39 C)
  • Bleeding from the rectum
  • Increasing abdominal swelling
  • Pain that is not relieved by your medications
  • Persistent nausea or vomiting
  • Chills
  • Persistent cough or shortness of breath
  • Purulent drainage (pus) from any location
  • Redness surrounding any of your incisions that is worsening or getting bigger
  • You are unable to eat or drink liquids


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