Fundoplication doctors in India

Best Fundoplication Surgery

What Is Fundoplication Surgery?

Fundoplication is a surgical procedure used to treat gastro-oesophageal reflux disease (GERD) and related conditions where stomach acid flows back into the oesophagus (food pipe). Normally, a muscle called the lower oesophageal sphincter (LES) acts as a valve between the stomach and oesophagus. When this valve becomes weak or doesn’t close properly, acid can move upward, causing symptoms like heartburn, regurgitation, chest pain, and difficulty swallowing. Fundoplication strengthens this valve by wrapping the top part of the stomach (fundus) around the lower oesophagus. This creates a tighter seal that helps prevent acid reflux.

The surgery can provide long-term relief for people whose symptoms are not well controlled with medicines or lifestyle changes. It can also help reduce complications of GERD such as oesophagitis (inflammation), strictures, and Barrett’s oesophagus. Fundoplication is usually done by a general surgeon using minimally invasive techniques, which means smaller cuts, less pain, and quicker recovery compared with open surgery.

Who May Need Fundoplication?

Fundoplication may be recommended for people who:

● Have severe or frequent acid reflux (GERD)

● Do not get adequate relief from medications

● Experience regurgitation or aspiration of stomach acid

● Have esophagitis or damage seen on endoscopy

● Develop respiratory symptoms (chronic cough, asthma-like symptoms) due to reflux

● Have a hiatal hernia contributing to reflux

● Want a long-term solution to reduce daily medicine use

Your surgeon evaluates symptoms, imaging studies (like endoscopy or pH monitoring), and overall health before suggesting fundoplication.

Types of Fundoplication

There are a few common approaches to fundoplication:

1. Nissen Fundoplication

The most common type. The top part of the stomach is wrapped 360 degrees around the lower oesophagus to create a strong valve.

2. Partial (Toupet or Dor) Fundoplication

Instead of a full wrap, the stomach is wrapped 180–270 degrees around the oesophagus. This may be chosen when a complete 360-degree wrap could cause difficulty swallowing.

3. Laparoscopic Fundoplication

Most fundoplication surgeries today are done laparoscopically (keyhole surgery), using small incisions and a camera to guide the surgeon, which leads to less pain and faster recovery.

The specific type is chosen based on the severity of reflux, oesophageal function, and the surgeon's judgement.

Fundoplication Procedure

Fundoplication is usually done under general anesthesia in a hospital operating room. The basic steps include:

1. Anesthesia and Positioning

You are given general anesthesia and positioned so the surgeon can access the upper abdomen.

2. Small Incisions and Laparoscopy

Several tiny incisions are made in the abdomen. A laparoscope (thin camera) and small instruments are inserted through these incisions.

3. Hiatal Hernia Repair (if present)

If a hiatal hernia is present, the diaphragm opening is tightened to keep the stomach in place.

4. Wrapping the Stomach

The top part of the stomach (fundus) is wrapped around the lower oesophagus and sutured in place. This reinforces the LES and reduces reflux.

5. Final Check and Closure

The surgeon checks the tightness of the wrap, ensures normal positioning, and closes the incisions.

The procedure usually takes 1.5–3 hours depending on complexity and whether a hernia repair is needed.

Recovery & Aftercare

After fundoplication surgery:

● Hospital Stay: Most people stay in the hospital for 1–3 days for monitoring and pain control.

● Pain and Discomfort: Mild to moderate discomfort at incision sites is common and can be managed with medications.

● Diet Progression: You’ll start with liquids, then soft foods, and gradually return to a regular diet over weeks.

● Activity: Light walking is encouraged soon after surgery. Avoid heavy lifting and strenuous exercise for 4–6 weeks.

● Follow-Up Visits: Your surgeon checks healing, discusses diet progression, and monitors reflux symptoms.

Most people return to regular activities within 2–4 weeks, but complete healing and dietary comfort may take longer.

Benefits of Fundoplication

Fundoplication may provide:

● Long-term relief from acid reflux symptoms

● Reduced need for long-term medication

● Healing of esophagitis

● Reduced regurgitation and aspiration

● Improvement in cough, hoarseness, or sleep-related reflux symptoms

● Strengthening of the lower esophageal valve

Risks & Possible Complications

Fundoplication is generally safe when done by experienced surgeons, but it carries some possible risks:

● Difficulty swallowing (dysphagia), especially right after surgery

● Gas bloat syndrome (difficulty with belching)

● Infection at incision sites

● Bleeding

● Wrap slippage or failure requiring revision surgery

● Reaction to anesthesia

Your surgeon reviews these risks with you and provides instructions to reduce complications.