Fundoplication—Open Surgery
Definition
Fundoplication is surgery to wrap the upper stomach around the
lower esophagus. This will create pressure on the lower part of the esophagus. This
lowers the amount of stomach acid that can move up the esophagus.
Reasons for Procedure
The surgery is done to treat severe gastroesophageal reflux disease (GERD). It may also be done to repair
a hiatal hernia, which can lead to GERD.
Possible Complications
Problems are rare, but all procedures have some risk. The doctor
will go over some problems that could happen, such as:
- Excess bleeding
- Problems from anesthesia, such as wheezing or sore throat
- Infection
- Problems swallowing
- Limited ability to burp or vomit
- Return of reflux symptoms
- Damage to the lining of the esophagus
- The need to repeat surgery due to the wrap slipping or a new hiatal hernia forming
(rare)
Things that may raise the risk of problems are:
What to Expect
Prior to Procedure
The surgical team may meet with you to talk about:
- Anesthesia options
- Any allergies you may have
- Current medicines, herbs, and supplements that you take and whether you need to
stop taking them before surgery
- Fasting before surgery, such as avoiding food or drink after midnight the night
before
- Whether you need a ride to and from surgery
Anesthesia
The doctor will give general anesthesia. You will be asleep.
Description of the Procedure
A large cut will be made in the belly. The upper part of the
stomach will be wrapped around the esophagus. If a hiatal hernia exists, the stomach
will be pulled back in the abdomen. The opening where the hernia poked through will
be tightened. The cut will be closed with stitches. A bandage will be placed over the
site.
How Long Will It Take?
2 to 4 hours
Will It Hurt?
Anesthesia will prevent pain during surgery. Pain and swelling
are common in the first few weeks. Medicine and home care can help.
Average Hospital Stay
2 to 4 days
Post-procedure Care
At the Hospital
After the procedure, the staff may:
- Give you pain medicine
- Start you on a liquid diet before moving you onto solid foods
During your stay, the hospital staff will take steps to lower your risk of
infection, such as:
- Washing their hands
- Wearing gloves or masks
- Keeping your cuts covered
During your stay, you can take steps to lower your risk of infection, such as:
- Washing your hands
- Wearing gloves or masks
- Keeping your cuts covered
At Home
It will take about six weeks to fully heal. Physical
activity will be limited. You may need to ask for help with daily activities and
delay your return to work.
Problems to Look Out For
Call the doctor if you are not getting better or you have:
- Signs of infection, such as fever and chills
- Redness, swelling, excessive bleeding, or any discharge from the cut
- Pain that you cannot control with medicine
- Lasting nausea or vomiting
- Problems swallowing that do not improve
- Problems passing urine or blood in the urine
- Cough, shortness of breath, or chest pain
- New or worsening symptoms
If you think you are having an emergency, call for medical help
right away.
Resources
National Institute of Diabetes and Digestive and Kidney Diseases
https://www.niddk.nih.gov
Society of American Gastrointestinal and Endoscopic Surgeons
https://www.sages.org
Canadian Resources
Canadian Association of Gastroenterology
https://www.cag-acg.org
Health Canada
https://www.canada.ca
References
Gastroesophageal reflux disease. EBSCO DynaMed website.
Available at: https://www.dynamed.com/condition/gastroesophageal-reflux-disease-gerd. Accessed
April 8, 2022.
Gastroesophageal reflux disease (GERD)/heartburn. The Ohio
State University Wexner Medical Center website. Available at:
https://wexnermedical.osu.edu/digestive-diseases/heartburn. Accessed April 8, 2022.
Hiatal hernia. EBSCO DynaMed website. Available at:
https://www.dynamed.com/condition/hiatal-hernia. Accessed April 8, 2022.
Nissen fundoplication. MUSC Health Digestive Disease Center
website. Available at:
https://muschealth.org/medical-services/ddc/patients/gi-surgery/laparoscopic-surgery/nissen-fundoplication.
Accessed April 8, 2022.