Anti-reflux surgery, also known as fundoplication, is a surgical procedure performed to treat gastroesophageal reflux disease (GERD) or severe acid reflux. This surgery aims to strengthen the lower esophageal sphincter (LES), the muscle at the bottom of the esophagus that normally prevents acid from refluxing into the esophagus. At SHIFAA PAN African Hospitals, our Gastroenterology department offers comprehensive evaluation and treatment options for patients with GERD, including anti-reflux surgery for those who do not respond to conservative management.

Symptoms:

GERD symptoms can significantly impact a patient’s quality of life. Common symptoms of GERD include:

• Heartburn or chest pain
• Regurgitation of food or sour liquid
• Difficulty swallowing (dysphagia)
• Chronic cough or hoarseness
• Sore throat or laryngitis
• Dental problems (erosion of tooth enamel)
• Asthma or worsening asthma symptoms

Diagnosis:

Before recommending anti-reflux surgery, patients typically undergo a series of diagnostic tests to confirm the diagnosis of GERD and assess its severity. These may include:

• Upper Endoscopy (EGD): A procedure in which a flexible tube with a camera is inserted through the mouth to visualize the esophagus and stomach. This allows the doctor to assess the lining of the esophagus for signs of inflammation or damage caused by acid reflux.
• Esophageal pH Monitoring: A test that measures the pH level (acid content) in the esophagus over a 24-hour period. This helps determine the frequency and severity of acid reflux episodes.
• Esophageal Manometry: A test that measures the strength and coordination of the muscles in the esophagus, including the LES. This helps assess whether the LES is functioning properly.
• Barium Swallow: A diagnostic imaging test in which the patient swallows a contrast material (barium) that coats the esophagus and stomach, allowing abnormalities to be visualized on X-ray.

Procedure:

During fundoplication surgery, the surgeon wraps the upper portion of the stomach (the fundus) around the lower end of the esophagus and sews it in place. This creates a valve mechanism that strengthens the LES and helps prevent acid reflux. Fundoplication can be performed using minimally invasive techniques (laparoscopic or robotic-assisted) or through open surgery, depending on the patient’s specific circumstances and the surgeon’s preference.

Postoperative Care:

After anti-reflux surgery, patients typically require a period of recovery before resuming normal activities. Postoperative care may include:

• Pain management: Patients may experience discomfort or pain at the incision sites, which can usually be managed with pain medications.
• Diet modifications: Following surgery, patients may need to adhere to a liquid or soft diet initially, gradually advancing to solid foods as tolerated.
• Activity restrictions: Patients may be advised to avoid heavy lifting or strenuous activity for a certain period to allow for proper healing.
• Follow-up appointments: Regular follow-up visits with the surgeon are essential to monitor progress, assess symptoms, and make any necessary adjustments to the treatment plan.

Fundoplication surgery is generally effective in relieving GERD symptoms and improving quality of life for many patients. However, like any surgical procedure, there are risks and potential complications to consider. It is important for patients to discuss the potential benefits and risks of surgery with their healthcare provider and to carefully follow postoperative instructions for the best possible outcome.

 

What is fundoplication surgery, and how does it help treat GERD?

Fundoplication is a surgical procedure that strengthens the lower esophageal sphincter (LES) to prevent acid reflux and relieve symptoms of GERD.

 

Who is a candidate for fundoplication surgery?

Patients with severe or refractory GERD symptoms who do not respond to conservative management (medications, lifestyle modifications) may be candidates for fundoplication surgery.

 

What diagnostic tests are used to assess GERD severity before recommending surgery?

Diagnostic tests such as upper endoscopy (EGD), esophageal pH monitoring, esophageal manometry, and barium swallow may be used to evaluate GERD symptoms and severity.

 

What are the different types of fundoplication surgery, and how are they performed?

Fundoplication can be performed using minimally invasive techniques (laparoscopic or robotic-assisted) or through open surgery, with variations such as partial or total fundoplication.

 

What is the recovery process like after fundoplication surgery?

Recovery after fundoplication surgery involves pain management, diet modifications, activity restrictions, and regular follow-up appointments with the surgeon.

 

What are the potential risks and complications of fundoplication surgery?

Risks of fundoplication surgery include infection, bleeding, difficulty swallowing, gas bloat syndrome, and recurrence of reflux symptoms.

 

What is the long-term outlook for patients who undergo fundoplication surgery?

Fundoplication surgery is generally effective in relieving GERD symptoms and improving quality of life for many patients, but long-term outcomes may vary depending on individual factors and adherence to postoperative care instructions.

 

• Thorough physical examination by a pediatric orthopedic specialist.
• Utilization of imaging techniques such as X-rays, CT scans, or MRIs.
• Genetic testing for identifying congenital conditions with hereditary factors.
• Thorough physical examination by a pediatric orthopedic specialist.
• Utilization of imaging techniques such as X-rays, CT scans, or MRIs.
• Genetic testing for identifying congenital conditions with hereditary factors.