Laparoscopic Nissen Fundoplication (for GERD)

What is Gastroesophageal Reflux Disease?

Gastroesophageal reflux disease (GERD) is a condition in which gastric contents from the stomach backflow into the esophagus. The esophagus is not made to resist acid, and so the acid burns the esophagus, causing the symptom of heartburn.

People with GERD may have heartburn, chest pain, hoarseness in the morning, or difficulty swallowing. Sometimes GERD makes a person feel as though he or she is choking, food is stuck in the throat, or the throat is tight. It also can cause a dry cough and bad breath.

How many people are diagnosed with GERD?

The U.S. Department of Health and Human Services reports that about seven million people in the country suffer from GERD.

How is GERD treated?

Depending upon the severity of GERD, treatment may involve one or more lifestyle changes, medications or surgery.

Surgery becomes an option when medicine and lifestyle changes aren’t successful or when those options aren’t reasonable alternatives.

How is laparoscopic Nissen fundoplication performed?

Fundoplication is the standard surgical treatment for GERD. The upper part of the stomach is wrapped around the lowest point of the esophagus to prevent acid reflux and repair a hiatal hernia.

Washington University minimally invasive surgeons can perform fundoplication as a laparoscopic (minimally invasive) procedure that requires only tiny incisions in the stomach.

In this type of procedure, a small incision is made and a trocar (hollow tube) is inserted. The abdomen is then filled with carbon dioxide gas to allow visualization of the abdominal organs. A scope with a light and camera is inserted into this trocar and the image is shown on TV monitors. Four more small incisions are then made and trocars are inserted to allow placement of the instruments used to perform the operation.

What are the advantages?

As with other minimally invasive procedures, patients who undergo laparoscopic Nissen fundoplication usually have fewer complications, a shorter hospital stay, less pain and a much faster recovery than with traditional open surgery.

Patients can generally leave the hospital one to three days after the procedure and return to work in two to three weeks.

What are potential complications?

Any surgery has the potential for complications such as bleeding or infection. There is less risk in the laparoscopic cases because of smaller incisions and reduced healing time.

Washington University in St. Louis surgeons who perform this procedure:

Michael M. Awad, MD
L. Michael Brunt, MD
J. Christopher Eagon, MD
Arghavan Salles, MD, PhD

For a patient appointment with a minimally invasive surgeon, please call (314) 454-8877.