Fundoplication

What is fundoplication?

Gastric fundoplication is surgery that restores normal lower esophageal sphincter (LES) function. This valve on the bottom of your esophagus opens when you swallow to allow food and fluids into your stomach. It closes afterward to stop stomach acid from entering the esophagus.

If you have gastroesophageal reflux disease (GERD), the LES doesn’t close properly after you swallow. Stomach acid can reflux back up your esophagus, causing burning pain (heartburn).

If medications that control stomach acid production don’t relieve GERD symptoms, your doctor at the Institute of Esophageal and Reflux Surgery could recommend fundoplication. You might need complete or partial fundoplication, depending on the extent of the LES damage.

What is complete fundoplication?

Complete or Nissen fundoplication involves wrapping the top of your stomach around the lower part of your esophagus. The procedure strengthens the LES, preventing acid reflux.

The Institute of Esophageal and Reflux Surgery team uses minimally invasive laparoscopic techniques to perform Nissen fundoplication. Instead of making large incisions in your abdomen, they make five or six small cuts just large enough to insert the laparoscopic instruments.

Your surgeon uses images sent back by a camera on the laparoscope to do the surgery. Laparoscopic Nissen fundoplication significantly reduces recovery time and pain after surgery compared to open techniques. The Institute of Esophageal and Reflux Surgery team usually reserves Nissen fundoplication to patients with severe reflux.

What is partial fundoplication?

Partial fundoplication involves wrapping your stomach only partway around your lower esophagus. The Institute of Esophageal and Reflux Surgery team finds most patients require only a partial rather than complete fundoplication.

The team has extensive experience with partial fundoplications. These procedures are very effective, causing fewer side effects than Nissen fundoplication.

An alternative to laparoscopic fundoplication is transoral incisionless fundoplication (TIF) using the EsophyX® Z+ device from EndoGastric Solutions® in Redmond, Washington. The EsophX device reconstructs the LES without needing surgical incisions.

How long does recovery from fundoplication take?

Most of the Institute of Esophageal and Reflux Surgery’s patients go home the same day as their fundoplication surgery. You’ll need pain medications for a few days. You must avoid lifting anything heavy or straining your abdominal area for about a month after surgery.

Over the first month, you need to follow a special diet: only eat foods that won’t harm or irritate the healing tissues. It’s common for patients to have shoulder pain following fundoplication surgery. Gentle heat should clear this up in a day or two.

You can return to work when you’re ready — usually in a week or two unless your job requires heavy lifting.

Call the Institute of Esophageal and Reflux Surgery today or book an appointment online to learn more about fundoplication and how it can relieve GERD symptoms.