Nissen Fundoplication for GERD
Chronic acid reflux or GERD affects tens of millions of Americans. Typically, patients begin their treatment regimen with medications to either suppress the production of stomach acid with proton pump inhibitors or neutralize it with antacids. However, as is the case with most medications, there are side effects and, ultimately, the root cause of the problem is not addressed.
Surgery for chronic acid reflux is a curative procedure because it reinforces the lower esophageal sphincter or LES, which in turn rebuilds the mechanism that blocks the regurgitation of stomach acid.
There are several surgical and nonsurgical options for the treatment of acid reflux. One of the most commonly performed, proven and minimally invasive surgeries is known as the laparoscopic Nissen Fundoplication.
How does the Nissen Fundoplication Work?
During this procedure, a portion of the upper stomach, known as the fundus, is wrapped around the lower part of the esophagus, essentially creating a compression sleeve that improves the function of the esophageal valve (LES). The stomach Is sutured in place for long-term results.
The Nissen fundoplication represents a 360° stomach wrap around the esophagus, however there are other fundoplications that including the Dor (front) and Toupet (back) fundoplication procedures that provide only partial coverage.
A partial or total fundoplication is typically reserved for patients that have not responded well to medical therapy or for whom drugs are no longer effective. Fundoplication is also the primary form of treatment for a paraesophageal hiatal hernia. Fundoplication (usually partial) may also be appropriate for patients who are at risk of developing GERD after a Heller Myotomy for the treatment of achalasia.
Most patients experience significant relief from their GERD symptoms after the fundoplication and we have seen excellent long-term results.
Risks and Considerations of a Fundoplication
As with any major surgical procedure there are risks inherent to surgery which are minimized by the laparoscopic nature of the procedure as well as the experience of the team here at our practice. However, there is always a risk of unexpected complications, which will be discussed at consultation.
Of course, all patients will be screened for their suitability for surgery to ensure that the benefits of a fundoplication outweigh the risks. If chronic acid reflex is no longer being managed well by medications or other conservative treatments, we encourage you to visit our office where we have several options for the treatment of GERD including the fundoplication and LINX medical device.