Fundoplication (for Hiatus Hernia & GERD) Treatment in Nagpur

Fundoplication is a surgical procedure primarily used to treat gastroesophageal reflux disease (GERD) and hiatus hernia. Here’s a detailed overview:

  • GERD (Gastroesophageal Reflux Disease): This condition occurs when stomach acid frequently flows back into the esophagus, causing irritation and inflammation.
  • Hiatus Hernia: This condition involves the protrusion of the stomach through the diaphragm muscle into the chest cavity, which can contribute to GERD symptoms.
  • Laparoscopic Approach: Fundoplication is typically performed using minimally invasive laparoscopic techniques. This involves making several small incisions in the abdomen, through which a tiny camera (laparoscope) and specialized surgical instruments are inserted.
  • Repositioning the Stomach: The surgeon will gently pull the stomach back into its normal position below the diaphragm.
  • Creating a Wrap: The surgeon wraps the upper part of the stomach (fundus) around the lower esophagus and sutures it in place. This wrap reinforces the lower esophageal sphincter (LES), the muscle that normally prevents stomach acid from flowing back into the esophagus.
  • Tightening the LES: By tightening the wrap around the esophagus, the surgeon helps to improve the function of the LES, further reducing the likelihood of acid reflux.
Types of Fundoplication:
  • Nissen Fundoplication: This is the most common type of fundoplication. It involves a complete 360-degree wrap of the fundus around the esophagus.
  • Partial Fundoplication (Toupet or Dor): In some cases, a partial wrap (usually 180 or 270 degrees) may be performed to reduce the risk of side effects like difficulty swallowing (dysphagia) or excessive gas and bloating.
  • Hospital Stay: Most patients can expect to stay in the hospital for 1 to 2 days following laparoscopic fundoplication.
  • Diet: Initially, a liquid or soft diet may be recommended to allow the surgical site to heal. Patients will gradually progress to a normal diet over several weeks.
  • Activity: Patients are typically encouraged to resume light activities soon after surgery but should avoid heavy lifting and strenuous exercise for a few weeks.
  • Medication: Pain medication and proton pump inhibitors (PPIs) may be prescribed to manage pain and reduce stomach acid production during the recovery period.
Risks and Complications:
  • Difficulty Swallowing (Dysphagia): This can occur due to the tightening of the LES. It usually resolves within a few weeks but may persist in some cases.
  • Gas and Bloating: Some patients may experience increased gas and bloating after surgery.
  • Wrap Disruption: In rare cases, the wrap created during fundoplication may loosen or come undone, requiring further surgery.
  • Infection: As with any surgical procedure, there is a risk of infection at the incision sites.
Long-Term Outcomes:
  • Symptom Relief: Fundoplication is effective in relieving symptoms of GERD in the majority of patients, with studies showing significant improvement in heartburn, regurgitation, and other symptoms.
  • Diet and Lifestyle Modifications: While fundoplication can provide long-term relief, patients are often advised to make dietary and lifestyle changes to further manage GERD symptoms. This may include avoiding trigger foods, elevating the head of the bed, and maintaining a healthy weight.

Fundoplication is generally considered a safe and effective treatment for GERD and hiatus hernia, offering long-term symptom relief and improved quality of life for many patients. However, as with any surgical procedure, it’s important for patients to discuss the potential risks and benefits with their healthcare provider.

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