What is Laparoscopic Fundoplication?
Laparoscopic fundoplication is a surgical procedure that treats gastro- esophageal reflux disease (GERD) or acid reflux. It is currently the “gold standard” for treating patients with gastro- esophageal reflux disease (GERD) who do not respond completely to medications or cannot take medications for various reasons.
Under normal circumstances, it is normal to have a small amount of acid to travel back up into the esophagus. However, if this occurs too often or causes troublesome symptoms then proper treatment is warranted.
The principle of the operation is to use to top of the stomach (the fundus) to wrap around the lower part of the esophagus to re- create the valve and reinforces the lower esophageal sphincter to stop acid from traveling up the esophagus that causes symptoms.
The advantages of Laparoscopic Fundoplication
When patients suffer from symptoms of acid reflux and other treatments were not successful, this operation can potentially relieve and eliminate the condition. Undergoing laparoscopic fundoplication may also reduce the risk of potential complications from gastro- esophageal reflux disease(GERD) such as esophagitis and Barrett’s esophagus.
The risks and successful rate of Laparoscopic Fundoplication
When laparoscopic fundoplication is performed by an experienced surgeon, >90% of the patients will be satisfied with the results of surgery. This operation not only can significantly improve the quality of life for those who suffer from acid reflux, most of them will have their symptoms resolved and can stop taking acid- suppression medications after the procedure.
No surgical procedure is free of risks. Serious complications after laparoscopic fundoplication is rare. The overall risks of laparoscopic fundoplication is less than 1%, comparable to many other general surgical procedures that are commonly performed. The following is a list of the possible complications:
- Bleeding
- Infection
- Damage to nearby structures in the operative field, such as intestines, liver or blood vessels.
- Perforation to the esophagus or stomach
- Difficulty in swallowing
- Persistent or incomplete control of reflux symptoms
Procedure guide of Laparoscopic Fundoplication
Laparoscopic fundoplication is a minimally- invasive surgical procedure that is done inside the hospital under general anesthesia. The following is an overall rundown of the surgery:
- You will be asked to stop eating and drinking about 6-8 hours before the surgery.
- The operation will be done in the hospital.
- You will receive general anesthesia by a qualified anesthesiologist.
- Your surgeon will make 5-6 small cuts on your abdomen where specialized instruments will be inserted into the abdomen to carry out the operation.
- The hiatus, which is the defect that the esophagus passes into the stomach is narrowed with stitches.
- The upper part of the stomach will be wrapped around the lower part of the esophagus and secured with stitches.
- The operative will take around 2 hours.
Instructions after Laparoscopic Fundoplication
Soon after the surgery, you will be woken up and escorted to the recovery room. Once your surgeon and nurses are satisfied that you are stable after the surgery, you will be taken back to the ward. The following is a list of what may happen after the surgery:
- You will likely be allowed to drink small amounts of water soon after the surgery.
- A mixture of oral and intravenous analgesics will be given to relieve the pain from the surgery.
- You will be encouraged to get out of bed and mobilize the next day and will be allowed to drink fluids.
- Most patient will stay in the hospital for 2 to 3 days after the surgery
- During the first few weeks after the operation, you will advised to eat a soft or pureed diet.
- During the first 10 days after the operation, you will be advised not to shower or get your wounds wet. This is mainly to help avoid wound infection.
- After the surgery, it usually takes around 1-2 weeks before you can return to work, depending on your type of work.
