Introduction

If you suffer from chronic acid reflux, you’re not alone. Millions of people experience this condition, caused by stomach acid flowing into the esophagus. While lifestyle changes and medications help many, some require surgical intervention, such as fundoplication. This guide explains fundoplication surgery in simple, accessible terms.

What is Fundoplication?

Fundoplication is a surgical procedure used to treat gastroesophageal reflux disease (GERD). The surgeon wraps the top of the stomach (the fundus) around the lower esophagus to create a valve-like mechanism. This strengthens the lower esophageal sphincter (LES) and prevents acid reflux.

Understanding GERD

GERD occurs when the LES becomes weak or relaxes inappropriately, allowing acid to rise into the esophagus. Over time, this can lead to inflammation, esophagitis, Barrett’s esophagus, or even esophageal cancer.

When is Fundoplication Recommended?

Fundoplication is recommended for patients with severe or persistent GERD symptoms unresponsive to other treatments. Indications include:

• Chronic heartburn or regurgitation despite medications
• Difficulty swallowing due to esophageal damage
• Respiratory issues like asthma or chronic cough linked to reflux
• Persistent esophageal inflammation or ulceration
• Barrett’s esophagus or precancerous conditions

Types of Fundoplication

There are two common types of fundoplication procedures:

• Nissen Fundoplication: A 360-degree wrap of the stomach around the esophagus. It's the most common method, offering strong reflux prevention.
• Toupet Fundoplication: A 270-degree partial wrap, preserving some LES function. Suitable for those with mild GERD or risk of post-op swallowing difficulty.

How is Fundoplication Performed?

Fundoplication is usually done laparoscopically. Small incisions are made in the abdomen, and a laparoscope with a camera and surgical tools is used. The surgeon wraps the stomach around the esophagus and secures it with sutures.

Benefits of Laparoscopic Fundoplication

• Smaller incisions and minimal scarring
• Shorter hospital stay and quicker recovery
• Less postoperative discomfort
• Reduced risk of infection and hernia formation

Recovery and Postoperative Care

Recovery depends on the procedure type and the patient’s overall health. General guidelines include:

• Pain Management: Mild to moderate discomfort is common. Use prescribed medications.
• Dietary Changes: Begin with soft or liquid foods. Gradually reintroduce solids and avoid irritants like spicy or acidic items.
• Activity Restrictions: Avoid heavy lifting and strenuous activity. Follow your doctor’s advice closely.
• Follow-Up Visits: Attend scheduled appointments to ensure proper healing.
• Long-Term Habits: Maintain a healthy weight, avoid smoking/alcohol, and use proper posture when eating and resting.

Potential Risks and Complications

While generally safe, fundoplication surgery may involve risks such as:

• Swallowing difficulties or persistent reflux
• Gas bloating or discomfort
• Anesthesia-related complications
• Injury to nearby organs
• Recurrent GERD or need for revision surgery

Discuss these risks with your surgeon and weigh them against the expected benefits.