FUNDOPLICATION: ANTI-REFLUX SURGERY

What is Fundoplication Surgery?

Fundoplication, also known as Anti-reflux surgery, is a highly effective surgical procedure, used to treat gastroesophageal reflux disease (GORD) and its associated symptoms, offering lasting symptom control.

GORD occurs when stomach acid flows backward (refluxes) into the oesophagus, causing typical symptoms like heartburn, chest pain, and acid regurgitation, and atypical symptoms such as chronic cough, poor dentition, worsening asthma and hoarseness of the voice.

A fundoplication is a procedure where the top of the stomach is wrapped around the lower oesophagus in the abdomen, to strength the lower oesophageal sphincter (LOS), our bodies’ “anti-reflux valve”, thus preventing acid reflux and protecting the oesophagus from damage. If an associated hiatus hernia is present, this will be fixed at the same time.

Am I a candidate for Fundoplication / anti-reflux surgery?

Fundoplication is typically recommended when:

  • You have ongoing significant reflux or heartburn that is troublesome, despite lifestyle changes and use of medications (despite using maximal doses) 

  • Severe oesophageal damage has occurred due to acid reflux (e.g., severe erosive esophagitis, bleeding, ulcers, reflux strictures, Barrett’s Oesophagus along with reflux)

  • There is a hiatal hernia that causes or worsens reflux

  • You are unable to tolerate, have had side effects from, or do not want to take, long-term medication for reflux

  • Personal preference

How is a fundoplication performed?

Dr. Stokes & Dr Hammerschlag at South East Upper GI Surgical Group specialise in performing minimally invasive (laparoscopic and robotic) hiatus hernia and fundoplication surgery.

Rather than using a big incision, they uses small incisions on the abdomen (typically 4-5, <1cm in size) and keyhole instruments to mobilise the top part of the stomach (fundus), elongate the oesophagus into the abdomen and the carefully “wrap” the fundus around the bottom most part of the oesophagus, using sutures, effectively creating a new “anti-reflux” valve mechanism, preventing reflux.

A number of different “degrees” of fundoplication exist, each offering their own advantages. A tailored, individualised approach is necessary in choosing which one is most suitable.

Nissen Fundoplication: Where the top of the stomach is wrapped 360 degrees around the oesophagus.

Toupet/Posterior 270 Fundoplication: The top of the stomach is wrapped 270 degrees around the oesophagus.

Dor/Anterior 180 Fundoplication: A partial wrap used in some cases for certain anatomical variations.

Dr. Matthew Stokes & Dr. Joshua Hammerschlag have both undertaken specialist training in all types of fundoplication and therefore take an individualised approach to “tailoring” the wrap/fundoplication to you and your symptoms.

What is the recovery time after fundoplication surgery?

Following minimally invasive fundoplication surgery, most patients stay in hospital 1-2 nights. When discharged, you will be provided with a comprehensive “patient information sheet” outlining expected recovery times, dietary guidelines and activity restrictions. The aim is to fully inform you to support you in your post operative period to achieve the best possible outcome after surgery. 

Personalised, Compassionate Surgical Care

South East Upper GI Surgical Group warmly welcomes both private and public patients for new consultations and can see urgent referrals quickly, including new cancer diagnoses.