Anti-Reflux Surgery

Anti-reflux surgery (also known as Nissen fundoplication) is a surgical procedure used in the treatment of gastroesophageal reflux disease (GERD).

What is Acid Reflux?

Acid reflux is a common condition that occurs when stomach acid travels up your oesophagus resulting in a burning pain in the lower chest area, known as heartburn. Acid reflux can lead to heartburn or acidic sensations in the mouth, which can cause the lining of the oesophagus to become reddened, swollen or scarred.  Surgery may be suggested if your symptoms continue after trying other medical methods that lower the acid content in your stomach.

Causes of Acid Reflux

If you suffer from reasonable to extreme heartburn, your doctor may suggest anti-reflux surgery.  Heartburn, also referred to as Gastroesophageal reflux disease is a digestive ailment that occurs in the lower oesophageal sphincter.  When you have GERD, the sphincter muscle becomes weak or fails to close properly, causing food and stomach acids to move back (reflux) into the oesophagus.

Symptoms of Acid Reflux

The lining of the oesophagus can become swollen, inflamed or irritated due to the acids, which may cause a burning chest pain and sometimes a sour taste or cough. Common signs and symptoms of GERD include:

• A burning feeling in your chest (heartburn)
• Chest pain
• Struggle swallowing
• A cough
• A sour taste in the mouth
• Feeling of a lump in your throat

There are steps you can take to manage GERD without undergoing surgery such as:

• Take medication to reduce acid in the stomach
• Lifestyle changes – maintain a healthy weight and quit smoking
• Avoid acidic foods
• Avoid lying down for a few hours prior to eating

Obesity, pregnancy and connective tissue conditions can all increase your risk of GERD.

Diagnosis of Acid Reflux

Your doctor might be able to identify GERD by performing a physical examination and looking at the history of your signs and symptoms.  To confirm a diagnosis of GERD, or to check for any complications, your doctor may suggest:

Upper GI Endoscopy

Also referred to as an EDG or Gastroscopy, this is a procedure where your doctor inserts a thin, flexible tube with a light and camera at the tip (endoscope) to examine the inside of your oesophagus, the stomach and the upper digestive tract.  This also gives your doctor a chance to collect a sample of tissue to test if necessary.  If reflux is present, test results can be normal but an endoscopy can also check for other complications.

X-ray of your upper digestive system

To perform this X-ray procedure, you will need to drink a chalky liquid that will allow the doctor to see an image of your oesophagus, stomach and upper intestine or swallow a barium pill to help analyse narrowing of the oesophagus that causes difficulty when swallowing.

Treatment and Procedure

If you suffer from severe oesophageal reflux, surgery may be necessary to correct the problem if symptoms are not relieved through other medical treatments.  If left untreated, gastroesophageal reflux can lead to complications such as oesophagitis, oesophageal ulcers and bleeding or scarring of the oesophagus.

Laparoscopic anti-reflux surgery is a minimally invasive technique that treats gastroesophageal reflux by making an effective valve mechanism at the bottom of the oesophagus.  The word laparoscopy means to assess the inside the abdominal cavity with a camera or “scope” (called a laparoscope).

Laparoscopic anti reflux surgery is typically performed under general anaesthetic and takes between 1-2 hours.

During laparoscopic anti-reflux surgery, your doctor will make several small incisions in the abdomen, then place surgical tools through the laparoscope inside your abdomen to carry out the procedure.  Carbon dioxide is used to inflate and lift the abdominal wall away from the organs below, so your doctor will have room to work.

Your doctor will stitch the diaphragm to reduce the size of the hole your oesophagus passes through.  They will then stitch or staple the top part of your stomach around the lower oesophagus, this creates a valve stopping excess acid from travelling into your oesophagus.  Following the surgery your doctor will close your wounds with stitches or staples.

Post-Operative Recovery

As laparoscopic surgery is a minimally invasive operation, you may be able to return home the following day after your operation.  You will be given pain relief medication during your stay in hospital to help alleviate any discomfort.

The laparoscopic anti-reflux surgery results in less pain and scarring, a quicker recovery time, and lower risk of infection than traditional open anti-reflux surgery. Most people can return to work (depending on the occupation) and their normal routine in a few weeks after the procedure.  Be sure to discuss this with your doctor.

A follow-up appointment will be arranged about one week after your surgery.  You will undergo a chest X-ray, and the doctor will evaluate the wound site.

Risks and Complications

Some people experience bloating, cramping and shoulder pain caused by the carbon dioxide that was used in the abdomen during surgery.  You will be given medicine to relieve your discomfort but your pain should subside during your hospital stay.

Anti-reflux surgery is a low risk operation and complications are uncommon.  However, as with any type of invasive surgery, there is always a risk of complications. Possible complications include:

• Pain
• Bleeding
• Infection of the surgical wound (incision)
• Unsightly scarring
• Blood clots 
• Injury to internal organs
• Developing a hernia near the surgical site
• Trouble swallowing
• Rip in the stitches holding the stomach
• Liver damage
• Reappearance of reflux

Taking part in regular exercise should help you to return to regular activities as soon as possible.  If you develop any problems following your anti-reflux surgery, you should speak to your doctor so that you can get any additional care that you need.

Outlook Following Acid-Reflux Surgery

Surgery is typically a last resort for treating GERD.  You should consider all options before deciding on surgery.  In most surgical techniques used to treat GERD, the outlook is very positive.  For most people with GERD, the surgery relieves or even eliminates their symptoms.

Need Help?

At One Healthcare we can book you in to see a specialist General Surgeon, usually within 48 hours, for an initial consultation.  Anti-Reflux surgery is available at One Ashford Hospital in Kent and One Hatfield Hospital in Hertfordshire.

You can use your private medical insurance or pay for your Anti-Reflux Surgery treatment. We offer competitive, fixed price packages as well as the ability to spread the cost of your treatment over a number of months. If you are using your health insurance, please contact your insurer first for approval and let them know you’d like to be treated at either the One Ashford Hospital or One Hatfield Hospital.

Why One Healthcare

• Modern purpose-built hospital opened in March 2016 (Ashford) December 2017 (Hatfield)
• Fast access to diagnostics including MRI, X-ray and Ultrasound
• Private, spacious, en-suite rooms
• Specialist Physiotherapy and nursing teams
• Little or no waiting time
• ‘Ultra clean air’ theatres
• Freshly prepared food
• Calm, dignified experience

Contact us and find out more

If you live in and around the Kent area and would like to visit our One Ashford Hospital please click here

If you are based in and around Hertfordshire and would like to visit the One Hatfield Hospital please click here.