Patients should never have to choose between superior surgical skills and warm, compassionate care. It’s true that sophisticated surgeries now seem almost commonplace, however, the surgeons of North Orlando Surgical group recognize that surgery is always a major undertaking for the patient. Our patients can feel confident that our surgeons are among the area’s best, widely recognized for our superior skills, low complication rate and excellent surgical outcomes
Nissen fundoplication, also referred to as a Lap Nissen, is a laparoscopic procedure performed for patients with gastroesophageal reflux disease (GERD). Many patients with reflux can be treated with medicines to decrease acid production in the stomach. This will minimize the damage to the esophagus from acid refluxed up from the stomach, and allow the esophagus to heal. However some patients continue to have severe symptoms of either regurgitation or incomplete healing of their esophagus despite high doses of medical therapy. These patients should consider surgery as another option.
The problem lies at the junction of the esophagus and stomach where a muscular valve (sphincter) should prevent acid from flowing upwards. If this sphincter mechanism fails, acid is free to reflux up into the esophagus causing damage. Surgery basically augments this lower esophageal sphincter by wrapping a portion of the stomach known as the fundus around the lower esophageal sphincter.
GERD is generally treated in three progressive steps:
• Life Style Changes: In many cases, changing diet and taking over-the-counter antacids can reduce how often and how difficult your symptoms are. Losing weight, reducing or eliminating smoking and alcohol consumption, and altering eating and sleeping patterns can also help.
• Drug Therapy: If symptoms persist after these life style changes, drug therapy may be required. Antacids neutralize stomach acids and over-the-counter medications reduce the amount of stomach acid produced. Both may be effective in relieving symptoms. This therapy needs to be discussed with your primary care provider and your surgeon.
• Surgery: Patients who do not respond well to lifestyle changes or medications or those who do not wish to continually require medications to control their symptoms, may consider undergoing a surgical procedure. Surgery is very effective in treating GERD.
Before your surgeon recommends surgery you will be asked to undergo several test to ensure you are a good candidate. One of these tests is called an esophageal manometry test, which measures whether your esophagus functions well. Once you have been advised that surgery is a good option for you, fundoplication will be scheduled. A laparoscopic fundoplication involves fixing your hiatal hernia, if present, and wrapping the top part of the stomach around the end of the esophagus to reinforce the lower esophageal sphincter, and this will recreate “one-way valve” that is meant to prevent acid reflux. You may need to stay on a liquid diet for a period of time to allow for any swelling to improve before progressing to soft foods, and then finally a regular diet. Your doctor will guide you as to how soon you may resume eating regular foods.
When choosing a surgeon it is important to choose based on experience and skill. At North Orlando Surgical Group we not only have this experience and skill, but also a level of caring and compassion that is unrivaled. We treat you as family. You deserve nothing less than the best!