GERD or Gastro Esophageal Reflux Disease is one of the digestive disorders. It usually affects the esophageal sphincter (a muscular ring connecting the esophagus with the stomach).
Usually in case of GERD treatment if a patient does not response to medication then Laparoscopic antireflux surgery is recommended. Laparoscopic antireflux surgery is also called as Nissen fundoplication.
Usually in case of GERD treatment if a patient does not response to medication then Laparoscopic antireflux surgery is recommended. Laparoscopic antireflux surgery is also called as Nissen fundoplication.
What is GERD (gastroesophageal reflux)?
There is a muscular ring called as esophageal sphincter. The role of this esophageal sphincter is to prevent food from out of the stomach and back up into the esophagus.
In
case of GERD, the sphincter muscle becomes weak and it fails to close tightly.
This causes food and stomach acids to flow back into the esophagus. This
process is called reflux. Since there is an acid flow in esophagus, the lining
in esophagus becomes inflamed or irritated and this may lead to chest pain,
burning sensation and sometimes a sour taste or cough.
GERD Management:
GERD can be
controlled with medication and lifestyle modification:
- Medications (to reduce acid in
the stomach)
- Decreasing the size of meals
- Try to reduce weight (if
overweight)
- Quitting smoking
- Avoiding eating certain acidic
foods (Acidic food irritate the esophageal lining)
- Avoid lying down for at least two
to three hours after eating
- Elevating the head of the bed six
inches
When is laparoscopic antireflux surgery necessary?
The first line of
treatment of GERD is medication and lifestyle modification. If a patient does
not respond to medication and it’s a chronic esophageal reflux case then
surgery is recommended. Chronic gastroesophageal reflux, if left untreated then
it may lead to some complication like esophageal ulcers, esophagitis, bleeding,
or scarring of the esophagus. So when medications
are not successful in treating chronic GERD then Laparoscopic antireflux
surgery is recommended.
Laparoscopic
antireflux surgery is a safe and minimally-invasive procedure. It creates an
effective valve mechanism at the bottom of the esophagus and thus corrects
gastroesophageal reflux.
Who can have laparoscopic antireflux surgery?
Laparoscopic
antireflux surgery is mostly recommended if medication is not successful and no
previous history of abdominal surgery and those who experience most symptoms of
reflux when lying down.
What is laparoscopy?
In laparoscopy, a
small camera called "scope" (called a laparoscope) is used to look inside
the abdominal cavity. Usually, during this surgical procedure, five or six small
incisions are made in the abdomen and the abdominal cavity is inflated with carbon
dioxide. This lifts the abdominal wall away from the organ and the surgeon gets an
operating space in the abdomen.
Through the incision, the laparoscope and surgical instruments are inserted. The surgeon is
guided by the Laparoscope which transmits a picture of the abdomen on a video
monitor.
Advantages
of laparoscopic antireflux surgery
Compared to
traditional antireflux surgery patients who have laparoscopic antireflux
surgery generally experience
·
Less Pain
·
Quick recovery
·
Less risk of
infection
·
Reduce hospital
stay
Laparoscopic antireflux surgery vs traditional antireflux surgery
Incision
- Laparoscopic antireflux surgery: Five 5-10 mm incisions required in
the abdomen
- Traditional antireflux surgery: Six-inch vertical incision required
Length of
Hospital Stay
- Laparoscopic antireflux surgery: Two days
- Traditional antireflux surgery: Five to six days
Recovery
- Laparoscopic antireflux surgery:
- Less or no
bleeding
- Less risk
of infection
- No
nasogastric tube needed
- Traditional antireflux surgery:
- Potentially
more bleeding and scarring after surgery
- Greater risk of infection after surgery
- Nasogastric tube needed
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