Surgery is only performed in severe cases of GERD.

Fundoplication

Fundoplication is the surgical procedure used to treat gastroesophageal reflux disease (GERD). A hiatal hernia , if present, may also be fixed during this procedure. A hiatal hernia occurs when a portion of the stomach pokes through an opening in the diaphragm and into the chest cavity. This increases the severity of GERD.

Fundoplication

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There are two methods used to perform a fundoplication:

  • Nissen Fundoplication/Open Surgical Procedure
  • Laparoscopic Procedure

Both procedures are performed with the patient under general anesthesia.

Nissen Fundoplication/Open Surgical Procedure – The surgeon makes a wide incision. This exposes the stomach and lower esophagus. The surgeon wraps the upper portion of the stomach around the esophagus. This creates pressure on the sphincter muscle at the bottom of the esophagus. If a hiatal hernia exists, the surgeon will also position the stomach back in the abdomen and narrow the opening in the diaphragm.

Laparoscopic Procedure – The doctor makes a small incision and inserts a laparoscope—a thin, flexible instrument with a light that allows the doctor to view the inside of the body on a view scope or on a screen. Gas is pumped into the abdomen to improve viewing. Other small incisions are made in the skin to allow for the insertion of surgical instruments. The doctor then wraps the stomach around the esophagus. If present, a hiatal hernia is repaired.

Each procedure takes several hours. The recovery period from an open procedure is usually about six weeks and about two weeks from a laparoscopic procedure. After successful fundoplication, some patients may be able to stop taking medication. Others may still require medication, but may need less or may experience significant relief from other symptoms of GERD.