Gastroesophageal reflux disease (GERD), gastric reflux disease, or acid reflux disease is defined as chronic symptoms or mucosal damage produced by the abnormal reflux of stomach acid to the esophagus. A typical symptom is heartburn.
This is commonly due to transient or permanent changes in the barrier between the esophagus and the stomach. This can be due to incompetence of the lower esophageal sphincter, transient lower esophageal sphincter relaxation, impaired expulsion of gastric reflux from the esophagus, or a hiatal hernia.
Laparoscopic Nissen Fundoplication
This surgery is performed under general anaesthesia.
If a combination of lifestyle changes and drug therapy does not remedy reflux symptoms, a Nissen Fundoplication can be a very effective surgical procedure to correct reflux. This procedure involves wrapping the upper portion of the stomach around the base of the esophagus to reinforce the strength of the lower oesophageal sphincter. Until recently, the procedure required a large abdominal incision. A hospital stay of 3-5 days was usually required, and the time to full recovery and return to work was measured in weeks.
A laparoscopic Nissen Fundoplication is a minimally invasive approach that involves specialized video equipment and instruments that allow a surgeon to perform the procedure through four tiny incisions, most of which are less than a half-centimetre in size. One advantage of this method is a brief hospitalization. Most of the time it will require an overnight stay. Other advantages include less pain (less of a need for pain medication), fewer and smaller scars, and a shorter recovery time.
Laparoscopic Nissen Fundoplication is a safe and effective treatment of GERD. However, in rare cases the laparoscopic approach is not possible because it becomes difficult to visualize or handle organs effectively. In such instances, the traditional incision may need to be made to safely complete the operation.