Laparoscopic fundoplication is a keyhole procedure performed for patients with severe acid reflux, Barrett’s oesophagus and symptomatic hiatus hernias where in patients have to rely on medicines to control their symptoms. It is done to prevent acid from the stomach travelling the wrong way into the oesophagus. The operation is predominantly laparoscopic although very occasionally, conversion to open surgery may be necessary. The procedure involves narrowing the defect through which the oesophagus passes into the stomach (called the hiatus) as well as wrapping the upper part of the stomach around the lower oesophagus (the wrap) to recreate the valve at the lower end of the oesophagus. The wrap itself may be complete or partial depending on the circumstances. The operation is carried out under general anaesthesia. Overnight hospital stay is to be expected, although some patients can go home on the same day. There are restrictions to food intake for the first few weeks after the operation. Sloppy and pureed food is advised for 6 weeks following the operation. heavy meals are to be avoided . Dietary advice will be provided before you go home. Anti-acid medication can be stopped immediately after the procedure.
Several types of fundoplication are possible:
Before selecting the eligible patient for laparoscopic fundoplication, it is necessary to examine patient’s esophageal motility study and ambulatory 24 pH-metry. Because all patients with GERD are not fit this surgery. Only a portion of the GERD patients who are having refractory or long-term symptoms can be considered as fit for laparoscopic fundoplication after obtaining the stated reports, that too be decided by a gastrosurgeon.
When you get to the hospital for the surgery, you’ll check in and be led into a room where you can change into a hospital gown. Then, your doctor will put intravenous (IV) tubes into your veins for both fluid regulation and anesthesia during the surgery. You’ll be asleep during the entire procedure. Each type of fundoplication has slightly different steps. But each takes about two to four hours and follows a similar overall procedure. Here’s a general overview of a fundoplication surgery:
Fundoplication surgery is most often used to treat GERD symptoms that are likely to be caused in part by a hiatal hernia and that have not been well controlled by medicines. The surgery may also be used for some people who do not have a hiatal hernia. Surgery also may be an option when:
Following laparoscopic fundoplication surgery, a patient is usually kept in hospital for a night. When a patient starts drinking after a day’s observation he/she is discharged from the hospital. Patient has to follow a dietary restriction for two weeks and after reviewing the post-operative position, according to surgeon’s advice patient may advance his dietary chart. A patient can resume normal activity in one week.
Risks or complications following fundoplication surgery include: