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Nissen-FundoplicationThis procedure is used to treat symptoms associated with gastroesophageal reflux disease (GERD). GERD is characterized by the reflux of stomach acid back into the esophagus. This type of reflux is generally due to a poorly functioning lower esophageal sphincter, which is the muscle that should control the regurgitation of acid and food once it has been swallowed and passed into the stomach. Therefore, the purpose of a fundoplication is to strengthen the barrier between the esophagus and stomach when the sphincter is not functioning normally.
There are two types of fundoplication: laparoscopic and "open".
Endoscopy is a simpler alternative to fundoplication that you may want to discuss with your physician. |
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In
this procedure, the part of the stomach closest to the esophagus, called the "fundus,"
is gathered, wrapped up and sewn around the lower esophageal sphincter. This
causes increased pressure at the lower end of the esophagus, which in turn
reduces reflux. If the patient's reflux is complicated by h
In
the laparoscopic procedure, 5 five millimeter incisions are made around the
patients abdomen. Through one of these incisions, the surgeon places a
laparoscope--a thin, viewing tube, which the surgeon uses as a guide through the
other organs and throughout the surgery. The images viewed by the laparoscope
are reflected on a TV monitor located inside the operating room. Through the
other four incisions, the surgeon will insert other tools which will be used to
clamp, grasp, cut and sew the fundus and lower esophagus. This type of
procedure is relatively painless and the recovery period is minimal compared to
the "open" method. The patient will probably be on a liquid diet for 3-7 days
after the surgery and begin to return to normal activities after a week.
Patients
who have had past surgeries in this area, or who are prone to bleeding profusely
may have an "open" fundoplication instead. During this procedure, one, longer
incision is made rather than 5 small incisions and there is no laparoscope to
assist the surgeon. The hospital stay is usually a few days and the recovery
period at-home is more painful and usually takes a few weeks.
