Laparoscopic Anti-Reflux Surgery
Laparoscopic Anti-Reflux Surgery is a surgical technique performed on the esophagus and stomach to treat gastroesophageal reflux disease (GERD). The patient is given general anesthesia. As many as five small incisions are made in the abdomen. One is used for the laparoscope which is attached to a camera that sends images to a video monitor. The other four incisions are used to hold or manipulate tissue in the abdomen. Carbon dioxide gas is injected, which pushes the abdominal wall away from the organs so that the surgeon can see them clearly . Parts of the esophagus and stomach are freed from surrounding tissue. If the opening in the diaphragm is too large around the esophagus (hiatal hernia), sutures are placed to tighten it. A flexible rubber tube (bougie) is passed down the esophagus and 2-3 sutures are used to tighten the hiatus.
The fundus of the stomach (portion closest to the esophagus) is wrapped around the esophagus. A flexible rubber tube (bougie) is passed down the esophagus to prevent the wrap from being too tight. To keep the wrap in place, the fundus (now on right side of esophagus) is sutured to the portion of the stomach located on the left side. A completed fundoplication resembles a bun surrounding a hot dog or buttoned shirt collar. The result is creating a one way valve effect in the esophagus to permit food to pass into the stomach and prevent stomach acid from flowing back into the esophagus. At the end of the surgery, carbon dioxide gas is removed.
Laparoscopic nissen fundoplication is considered a safe and effective treatment for GERD when previous medical management fails.
Once you have recovered from anesthesia, you will be transferred to your hospital room. After your surgery, the nurses will measure your intake and output of fluids. They will document all the fluids that enter your body, and measure and collect any urine or fluids you produce, including those from tubes or drains placed during surgery.
For 8 to 12 weeks after surgery, do not lift or push anything heavier than 5 pounds. Avoid activities that increase abdominal pressure, especially sit-ups. You are encouraged to gradually increase your activity level. Walking is great exercise to strengthen your muscles, improve blood circulation and clear your lung.
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