Laparoscopic Anti-Reflux Surgery

Gastro-oesophageal reflux disease (GORD), gastroesophageal reflux disease (GERD), gastric reflux disease, or acid reflux is a chronic symptom of mucosal damage caused by stomach acid coming up from the stomach into the esophagus. It occurs when the lower oesophageal sphincter does not close properly and stomach contents leak back, or reflux, into the oesophagus.

The main symptoms are persistent heartburn and acid regurgitation. Some people have GORD without heartburn – instead they experience pain in the chest, hoarseness in the morning, or trouble swallowing. You may feel like you have food stuck in your throat or like you are choking or your throat is tight. GORD can also cause a dry cough and bad breath.

Treatment

  • Life style modification
  • Medications including antacids, H2 receptor blockers (eg. Ranitidine), Proton Pump inhibitors (eg. Omeprazole)
  • Surgical treatment

Surgery is an option when medicine and lifestyle changes do not work. It is also an alternative to a lifetime of drugs and discomfort. The most common procedure is called a laparoscopic Nissen fundoplication.

In a fundoplication, the gastric fundus (upper part) of the stomach is wroapped, or plicated, around the lower end of the oesophagus and stitched in place, reinforcing the closing function of the lower oesophageal sphincter. The esophageal hiatus is also narrowed down by sutures to prevent or treat concurrent hiatal hernia, in which the fundus slides up through the enlarged esophageal hiatus of the diaphragm.

The procedure is now routinely performed laparoscopically. This involves specialized video equipment and instruments that allow a surgeon to perform the procedure through four tiny incisions, most of which are less than a half-centimetre in size. One advantage of this method is a brief hospitalization – most of the time it will only require an overnight stay. Other advantages include less pain, fewer and smaller scars and a shorter recovery time.