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Antireflux surgery

Anti-reflux Surgery

 A growing number of patients visit the doctors with symptoms of gastoesophageal reflux disease (aka GERD), a condition that implies the reflux of the stomach content into the pharynix and larynx due to the failing muscles of the esophagus. The first step in the anti-reflux treatment is a thorough guidance in lifestyle and diet modification, which can be followed by a number of medical options such as acid suppression therapy, proton pump inhibitors and anti-acid medication.

When symptoms like heartburn, chronic cough, hoarseness, bloating and esophageal bleeding  persist or worsen patients may consider antireflux surgery, an intervention that not only can handle GERD permanently but also can heal a hiatal hernia, which may contribute to the adverse symptoms of the reflux disease.

In antireflux surgery (also called fundoplication) the surgeon stitches wraps or places clips around the muscles where the esophagus meets the stomach stopping the stomach content from refluxing into the esophagus.

The Antireflux Surgery Procedure

  • The 2-3 hour long operation is performed under general anesthesia. It is a relatively safe procedure with high success and low complication rates. Around 95% of the patients experience instant improvement of the symptoms once recovered from the surgery.antireflux-surgery_Small
  • Before the surgery, certain lab tests (blood and pH check) and imaging tests (upper endoscopy and X-ray of the esophagus) are necessary to survey the health status of the patient.
  • Nowadays surgeons prefer to perform minimally invasive surgeries when possible to reduce bleeding, pain and recovery time. Laparoscopic antireflux surgery is gaining ground against traditional open surgery for these very reasons. In Laparoscopic antireflux surgery three tiny incisions are made in the abdomen and through them a camera, light source and special tools are inserted and handled with the help of a monitor.
  • The surgeon then “wraps” both the upper part of the stomach and the lower part of the esophagus tightening the muscles that hold the stomach closed.
  • An even less invasive anti-reflux method to bind the muscles of the esophagus is done by endoscopy: a thin flexible tube is inserted through the mouth to the meeting point of the esophagus and stomach. With the help of special clips, a camera and light source collectively called EndoClinch system, the esophageal muscles are strengthened to stop the reflux.

In either case patients after the surgery spend a 2-3 day monitoring period in hospital. When laparoscopic antireflux surgery is performed, patients can get back to their normal routine within 3 weeks.