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During fundoplication surgery, the upper
curve of the stomach (the fundus) is wrapped around the
esophagus and sewn into place so that the lower
portion of the esophagus passes through a small tunnel of stomach muscle. This
surgery strengthens the valve between the esophagus and stomach (lower esophageal sphincter), which stops acid from
backing up into the esophagus as easily. This allows the esophagus to
If a person has a
hiatal hernia, which can cause
gastroesophageal reflux disease (GERD) symptoms, it
will also be repaired during this surgery.
If open surgery (which requires a large
incision) is done, you will most likely spend several days in the hospital. A
general anesthetic is used, which means you sleep through the operation. After
open surgery, you may need 4 to 6 weeks to get back to work or your normal
If the laparoscopic method is used, you will most likely
be in the hospital for only 2 to 3 days. A general anesthetic is used. You will
have less pain after surgery, because there is no large incision to heal. After
laparoscopic surgery, most people can go back to work or their normal routine
in about 2 to 3 weeks, depending on their work.
surgery, you may need to change the way you eat. You may need to eat only soft
foods until the surgery heals. And you should chew food thoroughly and eat more
slowly to give the food time to go down the esophagus.
Fundoplication surgery is most often
used to treat GERD symptoms that are likely to be caused in part by a hiatal
hernia and that have not been well controlled by medicines. The surgery may
also be used for some people who do not have a hiatal hernia. Surgery also may
be an option when:
Risks or complications following fundoplication
For some people, the side effects of surgery—bloating
caused by gas buildup, swallowing problems, pain at the surgical site—are as
bothersome as GERD symptoms. The fundoplication procedure cannot be reversed,
and in some cases it may not be possible to relieve the symptoms of these
complications, even with a second surgery.
GERD can be annoying and even painful. But it is not a dangerous disease. For any GERD treatment to be worth trying, it needs to be very safe. For many people, especially those who have few problems taking medicine, surgery is not a good choice.
But when fundoplication surgery is
successful, it may end the need for long-term treatment with medicine.
When you are deciding between surgery and treatment with medicine, weigh the
cost, risks, and potential complications of the surgery against the cost and inconvenience of taking medicine.
Before surgery, additional tests
will usually be done to be sure that surgery is likely to help cure GERD symptoms
and to diagnose problems that could be made worse by surgery.
Second surgeries are harder to do, are less successful, and are
more risky. So it is extremely important that the first procedure be
considered carefully and be done by an experienced surgeon who is more likely
to be successful the first time.
Surgery to treat GERD is rarely
done on people who:
In special cases, other surgeries such as partial
fundoplication or gastropexy may be done instead of fundoplication
Complete the surgery information form (PDF)surgery information form (PDF)(What is a PDF document?) to help you prepare for this surgery.
Lundell L, et al. (2007). Seven-year follow-up of a randomized clinical trial comparing proton-pump inhibition with surgical therapy for reflux oesophagitis. British Journal of Surgery, 94(2): 198–203.
Other Works Consulted
Galmiche J-P, et al. (2011). Laparoscopic antireflux surgery vs esomeprazole treatment for chronic GERD. JAMA, 305(19):
Current as of:
March 18, 2014
Adam Husney, MD - Family Medicine & Peter J. Kahrilas, MD - Gastroenterology
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