GERD is a common problem and affects about 10%of the population. PPI therapy though effective has side effects and cannot be preferred for long term treatment. Antireflux surgery thus helps in long term control of GERD symptoms.
Fundoplication: This involves wrapping the Upper part of the stomach around the esophagus to strengthen the lower esophageal sphincter thus preventing reflux. There can be various degrees of wrap from 90 to 360 depending on patient symptoms and evaluation findings.
1. Not responsive to PPI therapy
2. Complications like strictures or Barrett’s esophagus
3. Young patients with concern of quality of life
4. Presence of hiatus hernia
1. Upper GI Endoscopy:To help diagnose stricture, Barrett’s esophagus, Hiatus hernia
2. 24-Hour pH Monitoring:Is considered Gold standard test for GERD
3. Esophageal Manometry: Helps evaluate the lower esophageal sphincter and also to detect any motility disorders
4. Contrast Radiographs: Detect Hiatus hernias, Shortened esophagus etc
Early Postoperative Complications:
4. Hemorrhage, Ileus, wound infection are very rare following laparoscopic surgery.
Late Postoperative Complications
1.Bloating sensation due to difficulty in belching and swallowing of air by patients. Usually dietary changes suffice to control symptoms. But rarely may need sutgical intervention.
2.Long term dysphagia may be due to failure of the wrap which may need repeat surgery.