Laparoscopic Fundoplication, a treatment of GERD

June 11, 2009

Surgical treatment of GERD depends on reconstruction of the junction of the esophagus and stomach, called the lower esophageal sphincter (LES). A weak LES is the most common cause of GERD. Although such surgery has been performed for over 50 years, the use of advanced laparoscopic techniques has made surgical treatment much easier. Studies show that an experienced surgeon is essential to obtain good results. Our surgeons are experts at anti-reflux surgery and the most experienced in this area of Georgia, with hundreds of successfully treated patients.

Surgical treatment requires a thorough preoperative evaluation which will usually include EGD, barium swallow or UGI, and esophageal function testing. With this information in hand, your surgeon can then discuss your treatment options. The most common surgery for GERD is Laparoscopic Nissen Fundoplication (LNF). This procedure typically requires several small punctures to insert the laparoscopic camera and instruments into the abdomen. The surgeon then uses an adjacent portion of the stomach—the fundus—to wrap around the defective LES and make it suitably resistant to gastroesophageal regurgitation. The surgery takes 45 minutes to 2 hours, depending on the complexity of the individual patient’s anatomy, prior surgeries or the need for more specialized techniques. Patients typically are discharged the following morning on a soft diet that they will follow for several weeks while healing occurs, and return to normal activities in about a week.

Our goal with surgery is to have complete control of heartburn and regurgitation, have no requirement for acid-reducing medications and allow the patient to eat whatever they like. Studies show patients treated surgically have a better quality of life than those managed with medication alone. One of the best ways to understand surgical treatment is to talk to someone who has been through it. If you’d like, we’ll have a former surgical patient contact you to discuss their experience.