Advanced laparoscopic fundoplication is a minimally invasive surgical procedure widely used to treat severe gastroesophageal reflux disease (GERD) and hiatal hernias. By reinforcing the lower esophageal sphincter, this technique helps prevent acid reflux and improves quality of life for patients who do not respond to medications. This guide covers the procedure, its success rates, and what to expect during recovery.
What Is Advanced Laparoscopic Fundoplication?
Advanced laparoscopic fundoplication, most commonly performed as a Nissen fundoplication, involves wrapping the top of the stomach (fundus) around the lower esophagus to create a new valve mechanism. This prevents stomach acid from flowing back into the esophagus, offering long-term relief from GERD symptoms. The laparoscopic approach uses small incisions, a camera, and specialized instruments, resulting in minimal scarring and faster recovery compared to open surgery.
Step-by-Step Procedure
- Patient Preparation: The patient is placed under general anesthesia and positioned in a reverse Trendelenburg position to optimize surgical access.
- Port Placement: Four to five small incisions are made in the abdomen for trocars (ports) that allow insertion of the laparoscope and surgical instruments.
- Mobilization and Dissection: The surgeon mobilizes the stomach fundus and carefully dissects around the esophagus, ensuring both anterior and posterior vagus nerves are preserved.
- Crural Closure: The diaphragmatic crura are sutured together to repair any hiatal hernia and close the diaphragmatic hiatus.
- Fundoplication: The stomach fundus is wrapped 360 degrees around the lower esophagus and secured with sutures to create a new valve.
- Calibration and Testing: A bougie (calibration tube) is inserted into the esophagus to ensure the wrap is not too tight, preventing swallowing difficulties.
- Final Inspection: The surgical field is checked for bleeding, and the incisions are closed.
Success Rates and Outcomes
Advanced laparoscopic fundoplication has high success rates, with studies showing that 85–95% of patients experience significant improvement or complete resolution of GERD symptoms. The procedure is particularly effective for patients with severe reflux or those who cannot tolerate long-term medication. Long-term follow-up studies indicate that most patients maintain symptom relief for years after surgery.
Recovery Process
- Hospital Stay: Most patients are discharged within 1–2 days after surgery.
- Diet: Patients typically start with liquids and gradually advance to soft foods over 2–4 weeks, avoiding hard, chewy, or spicy foods.
- Activity: Light activities can resume within a week, but strenuous exercise and heavy lifting should be avoided for 4–6 weeks.
- Pain Management: Most patients experience mild to moderate pain, managed with prescribed medications. Pain typically subsides within a few days.
- Follow-Up: Regular follow-up appointments are scheduled to monitor recovery and address any concerns.
Why Choose the Best Laparoscopic Surgeons?
The success of advanced laparoscopic fundoplication depends on the surgeon’s expertise and experience. Meerut is home to some of the best laparoscopic surgeons, who specialize in minimally invasive surgery and provide personalized care for each patient.
Conclusion
Advanced laparoscopic fundoplication is a safe and effective treatment for severe GERD and hiatal hernias, offering high success rates and a quick recovery.
For those seeking expert care, visit our clinic in Meerut or call us to book an appointment with Dr. Medhavi Tomar and Dr. Monika Singh Tomar for advanced Minimally Invasive Surgery and diagnosis.