reflux surgery is needed when the upper part of the stomach protrudes (herniates) into the chest (thorax). A bulge forms (a hiatus hernia) as the stomach pushes up through the diaphragm due to a weakness in the diaphragm opening.
Reflux Surgery in brief
Reflux surgery can vary from the repair of a small portion of the stomach moving upwards to a larger defect. With a larger defect it is possible for the whole stomach and other organs to migrate up out of the abdominal cavity and up into the chest.
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What is Fundoplication?
Fundoplication is the name for the surgical procedure used to repair a hiatal hernia. The procedure can be performed via open incision or keyhole (laparoscopic) approach, through the abdomen or through the chest.
The procedure involves moving the lower end of the oesophagus and freeing the upper part of the stomach from the pinch point in the diaphragm. (The diaphragm acts like a flat, stretchy barrier separating the lungs above from the stomach and intestines underneath.)
The hernia is reduced by bringing stomach below the diaphragm. Then the opening on the diaphragm is narrowed with sutures. The repair is called a diaphragmatic crural repair or cruroplasty.
During the Procedure
To prevent recurrence of the hiatal hernia and reflux of gastric acid, the gastric fundus (upper part of the stomach) is wrapped around the lower part of the oesophagus. The surgeon can reinforce large defects and weak tissue with a synthetic or biological mesh.
After the Procedure
Most people recover from the laparoscopic reflux surgery quickly. In rare cases after reflux surgery, a person can have bloating and discomfort from gas build up because the person is not able to burp, has excess gas or flatulence. The surgeon will provide post surgical guidance to prevent the recurrence of the hernia, mesh infection or mesh erosion. Complications are fairly uncommon and 90% of the surgeries are a success.
A person needs to notify the surgeon if the heartburn comes back or has difficulty swallowing. In a few cases, the surgeon may need to prolong a person’s hospitalization or repeat the surgery.