GERD occurs when the lower esophageal sphincter (LES), the opening to your stomach, doesn't work normally. It allows food and stomach acid to travel back (reflux) into the esophagus.
GERD is sometimes treated with over-the-counter antacids that you can buy without a prescription. Your doctor may prescribe other medication to help with digestion if the antacids don't provide enough relief. Your doctor may also perform a procedure called dilations to stretch the esophagus. If these treatments have not brought you relief, your doctor may recommend a surgical procedure called laparoscopic fundoplication.
Laparoscopic Surgery is performed by re-creating the LES by wrapping the very top of the stomach around the lower part of the esophagus. The surgery usually lasts from 2 to 4 hours. Laparoscopic surgery is performed through several small incisions instead of a single long one, as in a traditional open procedure. As a result, there is less pain, a quicker recovery time, a shorter hospital stay, and lower risk of infection.
Preparing for Surgery: If you smoke, try to quit beforehand, since smoking adds risk to surgery and recovery. You may also have to stop taking certain medications. Before surgery, your general health will be checked with routine blood and other tests. You will be admitted to the hospital, usually on the same day as your surgery.
Before Your Surgery: You will be asked to sign a consent form authorizing your doctor to perform the surgery. You may also be given a mild laxative or enema to clear your system. An anesthesiologist may meet with you to discuss the type of anesthesia that will be used to keep you free of pain throughout surgery.
During Surgery: First you will be given an anesthetic and any other medications through an IV (intravenous) tube. You will be asleep during the surgery. Your abdomen will be inflated with carbon dioxide (CO2) gas to provide more space for your doctor to see and work. The laparoscope, which has a camera attached, is then inserted through an incision to send images to a video screen. Small surgical instruments may be inserted through the other incisions. The Co2 gas is removed at the end of at the end of surgery.
Open Fundoplication Surgery
If your doctor feels it is not safe to continue with a laparoscopic procedure once surgery has started, he or she will complete the operation through a larger incision in your abdomen. This is called an open procedure, or open fundoplication. This surgery requires a longer recovery time, up to 1 week in the hospital and from 4 to 6 weeks at home.
After you wake in the recovery room, you will be given extra oxygen to help you breathe. You may also have an IV in your arm for fluids and medication. You will have small bandages over your incisions, and you will be given medications to relieve any discomfort you may feel. Later that day or the next morning, you will probably be out of bed and walking around. Within a day or so after surgery, you will start a liquid diet. Your doctor will determine when you can begin eating soft foods.
Most people go home 1 to 3 days after laparoscopic surgery and return to work in 1 to 2 days. Because only small incisions are made, you will likely experience less pain than after open surgery. You may be able to start on a liquid diet soon after surgery. When your small incisions heal, the scars may be nearly invisible. Best of all, you will be able to eat without the pain and discomfort that GERD can cause.
At Home: Take it easy when you return home. Do not do any heavy lifting or vigorous activities. Follow your doctor’s advice about showering, driving and returning to work. Eat slowly and be careful about what you eat: Eat frequent, small meals and avoid carbonated drinks
Follow Up: During the first week to month after surgery, your doctor may meet with you to check on your progress and answer your questions. If you have any skin staples or stitches, they will be removed. This is a good time to ask your doctor for tips on maintaining a healthy diet after you are fully recovered. Any follow-up visits will be scheduled as needed.
Be sure to call your doctor if you develop any of the following:
- Fever (over 101F) or chills
- Bleeding from the incision(s)
- Increased abdominal swelling or pain
- Nausea or vomiting
- Cough or shortness of breath