Fundoplication is one of the most common surgical operations to treat heartburn caused by gastroesophageal reflux disorder (GERD). GERD is a frequent backup of stomach acid or contents into your esophagus.
Gastroesophageal Reflux Disorder can weaken the muscles that help transport food down into your stomach, including the sphincter that closes the opening between the esophagus and stomach. Fundoplication helps to strengthen this opening to stop food and acid from going back up.
What the surgery does
The lower esophageal sphincter (LES) is a one-way valve at the top of the stomach. It prevents food and fluid from flowing backward. Your lower esophageal sphincter is weak. It does not close off the top of your stomach. This means that food and fluid is able to flow back into your esophagus. During fundoplication, the lower esophageal sphincter is reorganized. This is done by wrapping the very top of the stomach around the lower part of the esophagus.
Two types of surgery
The surgical operation is regularly done with laparoscopy. But it may also be done with open surgical procedure.
Laparoscopy: This surgical operation uses a few small incisions. A thin, lighted tube known as laparoscope is used. This scope allows the doctor see inside your body and work through the small incisions.
Open surgery: This surgical operation uses one large incision. The doctor sees and works through this incision. This method may be used if your doctor feels it isn’t safe to continue with laparoscopic surgery.
During the surgery
An IV (intravenous) line is inserted into a vein in your arm or hand. This line gives you fluids and medicines. You are then given anesthesia so that you don’t feel pain during the surgery. Regularly, general anesthesia is used. This puts you into a deep sleep during the surgery. Below are the general steps once surgical procedure begins.
- The doctor makes two to four small incisions in your abdomen. The scope is inserted into one of the incisions. The scope transmits live pictures to a video screen. This allows the doctor see inside your abdomen.
- Tiny surgical equipment are placed through the other small incisions.
- Your abdomen is filled with carbon dioxide. This gas provides space for the medical doctor to see and work.
For open surgery:
- One large incision is made.
- The esophagus travels through an opening in the diaphragm known as the hiatus. You have a hiatal hernia if your stomach has gone up into the chest area. If this is the case, the hiatus is tightened with a few stitches.
- The stomach is wrapped around the outside of the esophagus. The wrap is stitched into place.
- When the surgical operation is done, all equipment are removed. Any incisions are closed with stitches or staples.
Risks and complications of fundoplication
- Injury to the liver, spleen, esophagus or stomach.
- Increased gas or bloating.
- Not able to vomit
- Trouble swallowing
- Not able to get rid of GERD.
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