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by Mahnke D

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.

Fundoplication
Fundoplication
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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

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

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.

Revision Information