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Laparascopic Anti-Reflux (GERD) Surgery

Anti-Reflux surgery is the standard surgical method of treating acid reflux or Gastroesophageal reflux disease (also known as GERD). Reflux disease is the result of acid refluxing from the stomach back up into the esophagus. This causes inflammation and pain (heartburn). Reflux generally occurs if the muscles where the esophagus meets the stomach do not close tightly enough.

What Causes GERD

When we eat, food travels from our mouth to stomach through esophagus (a tube from mouth to the stomach). At the bottom of the esophagus is a small ring of muscle called lower esophageal sphincter (LES) that acts like a one way valve, allowing food to pass through into the stomach. LES closes immediately preventing stomach juices, which have a high acid content, back into the esophagus. In some people LES does not function properly allowing acid to flow back and burn the lower esophagus causing heartburn and if not treated may damage the esophagus. Symptoms of GERD are burning in the stomach that you may also feel in your throat or chest, burping or gas bubbles, or trouble swallowing food or fluids.

Who needs Anti reflux Surgery?

Most people suffering from reflux diseases or GERD responds well to acid suppressing drugs and do not need any surgery. However, for for some patients anti reflux surgery would be necessary. There are 3 main reasons patients wish to have surgery :

  • Failure to respond to adequate doses of medication
  • Major side effects from medication
  • Do not want to be on long-term medication

Laparoscopic antireflux surgery (also known as fundoplication) is used in the treatment of GERD when medicines are not successful. Laparoscopic antireflux surgery is a minimally-invasive procedure or keyhole surgery that corrects gastroesophageal reflux by reducing the hiatal hernia, reconstructing the esophageal hiatus and reinforcing the lower esophageal sphincter. We have expert laparoscopic surgeon in Mumbai who have successfully performed hundreds of anti reflux surgery.

What does the Laparoscopic surgery involve?

If the operation is being carried out for the first time, then in most cases laparoscopic surgery is a better option than open surgery, which involves a larger incision. In laparoscopic method need small incision and leads to a speedier recovery and less post-operative pain.

Most patients with GERD have a hiatus hernia associated with their reflux disease and repair of this hernia is undertaken at the same time as anti-reflux surgery. The hernia sac is pulled down from the chest and stitched so that it remains within the abdomen. Additionally the opening in the diaphragm, through which the esophagus passes from the chest into the abdomen, is tightened. During the surgical operation, the part of the stomach that is close to the entry of the esophagus is gathered, wrapped and stitched around the lower end of the esophagus. The laparoscopic anti reflux surgery usually takes around 1½ – 2 hours.

Are there any complications?

Like any surgery be it open or laparoscopic there are some risks. These relate to the anesthetic, others relate to general complications that can happen after any surgical operation, as well as specific problems unique to anti reflux laparoscopic surgery. General complications include :

  • Bleeding or bruising associated with the skin incisions.
  • Breathing complications, such as a collapsed lung. This is very rare.
  • Infection in the skin incisions can occur during the recovery period any may require antibiotic treatment.
  • Deep vein thrombosis and pulmonary embolism. It is more common with over weight patients and occurs generally after a prolonged periods of immobility.

How long dose it take to recover after anti reflux surgery?

Most patients have little pain after laparoscopic surgery and some chest discomfort. Many patients do experience
some degree of discomfort in their shoulders after the procedure. Such discomfort and soreness tends to disappear in 1-2 days. As the surgery has been performed laparoscopically, many people are able to return next day from the hospital.