Fundoplication is surgery to wrap upper stomach around the lower esophagus. It reduces the amount of acid that enters the esophagus from the stomach. Laparoscopic procedures use small incisions rather than the large incisions that are used during open surgery.
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The surgery is most often done for the following reasons:
gastroesophageal reflux disease
(GERD) symptoms that are not relieved by medication
Reduce acid reflux that is contributing to
Repair a hiatal hernia, which may be responsible for making GERD symptoms worseReduce of serious, long-term complications resulting from too much acid in the esophagus
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like: Anesthesia-related problemsInfectionBleedingDifficulty swallowingReturn of reflux symptomsLimited ability to burp or vomitGas painsDamage to other organs
In rare cases, the procedure may need to be repeated. This may happen if the wrap was too tight, the wrap slips, or if a new hernia forms.
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications, such as: SmokingDrinking
Chronic diseases, such as
Your doctor may do the following: Physical examX-ray
with contrast—to assess the level of reflux and evidence of damage
—use of a tube attached to a viewing device called an endoscope to examine the inside of the lining of the esophagus and stomach;
may also be taken
Manometry—a test to measure the muscular contractions inside the esophagus and its response to swallowing
Leading up to the surgery:
Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure, like:
Anti-inflammatory drugsBlood thinnersAntiplateletsArrange for a ride to and from the hospital. Also, arrange for help at home.The night before, eat a light meal. Do not eat or drink anything after midnight.
will be used. It will block any pain and keep you asleep through the surgery.
A small incision will be made. A laparoscope is a small tool with a camera on the end. It will be inserted into the abdomen. It will allow the doctor to view the inside of the body on a video screen. Gas will be pumped into the abdomen to improve the view. Other small incisions will be made in the skin. Small surgical instruments will be inserted. The stomach will then be wrapped around the esophagus. If needed, any hernia will be repaired.
In some cases, the doctor may need to switch to an
. A wide incision in the abdomen will be made to do the surgery.
Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.
Two days or more, depending on your condition
After surgery, you can expect the following: Walk with assistance the day after surgery.Keep the incision area clean and dry.Ask your doctor about when it is safe to shower, bathe, or soak in water.You will start by eating a liquid diet. You will slowly be able to eat more solid foods.After a successful fundoplication, you may no longer need to take medications for GERD.Be sure to follow your doctor's
It will take about two weeks to recover.
During your stay, the hospital staff will take steps to reduce your chance of infection, such as: Washing their handsWearing gloves or masksKeeping your incisions covered
There are also steps you can take to reduce your chance of infection, such as: Washing your hands often and reminding visitors and healthcare providers to do the sameReminding your healthcare providers to wear gloves or masksNot allowing others to touch your incision
Call your doctor if any of these occur: Signs of infection, including fever and chillsRedness, swelling, increasing pain, excessive bleeding, or any discharge from the incision siteNausea and/or vomiting that you cannot control with the medications you were given after surgery, or which persist for more than two days after discharge from the hospitalIncreased swelling or pain in the abdomenDifficulty swallowing that does not improvePain that you cannot control with the medications you have been givenPain, burning, urgency or frequency of urination, or persistent bleeding in the urineCough, shortness of breath, or chest painAny other new symptoms
If you think you have an emergency, call for medical help right away.
Fundoplication (lap Nissen). MUSC Health Digestive Disease Center website. Available at: http://www.ddc.musc.edu/surgery/surgeries/laparoscopic/fundoplication.cfm. Updated April 30, 2013. Accessed December 9, 2013.
Treating GERD. Ohio State University Medical Center website. Available at:
Accessed December 9, 2013.
7/30/2012 DynaMed's Systematic Literature Surveillance
http://www.ebscohost.com/dynamed: Niebisch S, Fleming F, et al. Perioperative risk of laparoscopic fundoplication: safer than previously reported—analysis of the American College of Surgeons National Surgical Quality Improvement Program 2005 to 2009.
American College of Surgeons.
Last reviewed December 2013 by Marcin Chwistek, MD; Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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