Laparoscopic Nissen Fundoplication

This webpage will give you information about a laparoscopic Nissen fundoplication. If you have any questions, you should ask your GP or other relevant health professional.

What is acid reflux?

Acid reflux is a condition where acid from the stomach travels up into the oesophagus (gullet). This happens if the valve between the stomach and the oesophagus does not work effectively. Acid reflux can cause ‘heartburn’ or acid in the back of the mouth.

What are the benefits of surgery?

Surgery is aimed at curing the symptoms of acid reflux.

Are there any alternatives to surgery?

Drugs that lower the acid content in the stomach are effective at controlling symptoms and healing inflammation. Surgery is only recommended if the symptoms continue or if you would prefer not to stay on medication.

What does the operation involve?

The operation is performed under a general anaesthetic. The laparoscopic (‘keyhole’) technique is usually used. Your surgeon will make several small cuts on your abdomen. They will place surgical instruments, along with a telescope, inside your abdomen and perform the operation (see figure 1).

The technique for laparoscopic surgery

Figure 1 - The technique for laparoscopic surgery

Your surgeon will stitch the diaphragm to reduce the size of the hole the oesophagus passes through. They will then wrap and stitch the top part of the stomach around the lower oesophagus, to produce a valve effect.

What complications can happen?

1 General complications of any operation

Pain
Bleeding
Infection in the surgical wound
Unsightly scarring
Developing a hernia in the scar
Blood clots

2 Specific complications of this operation

a Laparoscopic complications

Damage to internal organs
Developing a hernia near one of the cuts
Surgical emphysema

b Nissen fundoplication complications

Difficulty swallowing for the first few months
Air in the chest cavity
Making a hole in the oesophagus or stomach
Tear of the stitches used for the wrap
Damage to the liver Long-term problems
Continued difficulty swallowing
Incomplete control of reflux symptoms
Weight loss
Abdominal discomfort
Diarrhoea

How soon will I recover?

You should be able to go home within a few days. You should be able to return to work after three to four weeks but this may vary depending on the extent of surgery and your type of work. You should make a full recovery, with the symptoms of acid reflux gone or much improved.

Summary

Acid reflux can cause heartburn or acid in the mouth. The acid can cause the lining of the oesophagus to become inflamed or scarred. Surgery may be recommended if your symptoms continue while you are on medication.