General Surgery

GERD Surgery - Laparoscopic Nissen Fundoplication

What is a laparoscopic Nissen fundoplication?

Laparoscopic Nissen fundoplication is currently the ‘gold-standard’ for treating GERD in patients who don’t respond completely to medications or can’t take medications for another reason. Laparoscopic Nissen fundoplication is the most commonly performed antireflux procedure. Laparoscopic procedures are performed through very small incisions while the surgeon watches on a video monitor. During surgery, the top of the stomach (the fundus – hence the term fundoplication) is wrapped around the bottom of the esophagus. Another term for the fundoplication is a ‘wrap’. This essentially repairs the valve at the end of the esophagus that doesn’t work properly in patients with GERD. As opposed to medications for GERD, surgery stops all reflux – digestive enzymes AND acid. Because of this, surgery can cure reflux like medications can’t. If a hiatal hernia is present, this is fixed at the same time as the Nissen fundoplication.

What are the results of laparoscopic Nissen fundoplication?

When performed by an experienced surgeon, the results of GERD surgery are excellent.

  • Living with poorly controlled GERD symptoms can affect a patient’s quality of life. Studies show that quality of life is significantly improved after surgery for GERD
  • GERD-related symptoms reliably resolve in a high percentage of patients after surgery
  • Most patients are able to stop taking acid-suppression medications
  • Most patients are satisfied with the results of surgery (>90%)
  • Most patients are discharged from the hospital on the morning after their surgery and return to a normal lifestyle in 2-4 weeks

What are the possible complications of laparoscopic Nissen fundoplication surgery?

Serious complications after laparoscopic antireflux surgery are rare. For an in-depth discussion of the risks, options, and alternatives to laparoscopic Nissen fundoplication, please make an appointment with a surgeon.

Are there any side effects?

Side effects can occur, but in most cases these wane with time. Abdominal bloating can occur after fundoplication, but is rarely severe. Difficulty swallowing (dysphagia) is another side effect that tends to improve in most patients with time – provided food is chewed thoroughly. The majority of patients are able to belch easily when necessary; especially once some time has passed following surgery.

Hiatal Hernia and Fundoplication