Fundoplication

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Fundoplication surgery wraps the upper stomach around the lower esophagus. It reduces the amount of acid that enters the esophagus from the stomach. This procedure can:

  • Eliminate gastroesophageal reflux disease (GERD) symptoms that are not relieved by medication
  • Reduce acid reflux that is contributing to asthma symptoms
  • Repair a hiatal hernia, which may be responsible for making GERD symptoms worse
  • Reduce of serious, long-term complications resulting from too much acid in the esophagus

What to Expect

Evaluation Steps

Your doctor may do the following:

  • Physical exam
  • X-ray with contrast, to assess the level of reflux and evidence of damage
  • Endoscopy 
  • Manometry — a test to measure the muscular contractions inside the esophagus and its response to swallowing

Preparing for Fundoplication

  • Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure, like:
    • Anti-inflammatory drugs such as ibuprofen and naproxen
    • Blood thinners
    • Anti-platelet medications
  • Arrange for a ride to and from the hospital. Also, arrange for help at home.
  • The night before, eat a light meal. Do not eat or drink anything after midnight.

The Fundoplication Procedure

Your surgeon will:

  • Make a wide incision in your abdomen to expose the stomach and lower esophagus
  • Wrap the upper portion of the stomach around the esophagus, creating pressure on the lower part of the esophagus

If a hiatal hernia exists, the surgeon will:

  • Place your stomach back in the abdomen
  • Tighten the opening where the stomach had poked through the diaphragm 

Fundoplication Facts

The procedure:

  • Requires general anesthesia to block any pain and keep you asleep through the surgery
  • Takes 2-4 hours
  • Will cause discomfort during recovery
  • Can results in a hospital stay of 2-4 days

Recovery

After the procedure, you can expect to:

  • Walk with assistance the day after surgery
  • Keep the incision area clean and dry
  • Wait until your doctor says it's safe to shower, bathe or soak in water
  • Start by eating a liquid diet
  • No longer need to take medicines for GERD

Possible Risks

Possible complications, which may include:

  • Infection
  • Bleeding
  • Difficulty swallowing
  • Return of reflux symptoms
  • Limited ability to burp or vomit
  • Gas pains
  • Damage to organs
  • Anesthesia-related problems

In rare cases, you may need the procedure repeated. This may happen if the wrap was too tight, the wrap slips, or if a new hernia forms.

Some factors that may increase the risk of complications include:

  • Pre-existing heart or lung condition
  • Obesity
  • Smoking
  • Diabetes
  • Prior upper abdominal surgery

After you leave the hospital, contact your doctor if any of the following occurs:

  • Signs of infection, including fever and chills
  • Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision site
  • Nausea and/or vomiting that you cannot control with the medications you were given after surgery, or which persist for more than two days after discharge from the hospital
  • Increased swelling or pain in the abdomen
  • Difficulty swallowing that does not improve
  • Pain that you cannot control with the medications you have been given
  • Pain, burning, urgency or frequency of urination, or persistent bleeding in the urine
  • Cough, shortness of breath, or chest pain
  • Any other new symptoms

In case of an emergency, call for medical help right away.