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Laparoscopic Anti-reflux Surgery
All people have some level of heartburn. However, when these episodes occur several times a week patients should given serious consideration to surgical correction of the underlying disorder.
The technical term for heartburn is gastro-esophageal
reflux disease (GERD). It occurs when there is loss of the normal
sphincter anatomy between the esophagus and stomach. In some cases
the stomach is actually pushed into the chest cavity. The distortion
allows contents within the stomach to wash back into the esophagus,
and sometimes even the airway. Heartburn is painful because the
stomach fluids are very acidic. These fluids can be neutralized
with medications and antacids but the distortion still exists and
low grade irritation still occurs despite the medical treatment.
Patients who require antacid medication more than twice a week
should consider a surgical repair of the underlying distortion.
Anti-reflux surgery (also known as a “fundoplication”) is best performed under laparoscopic guidance. During surgery a tube-like fiber optic surgical scope is inserted into the abdominal cavity through a one centimeter umbilical incision. Three other laparoscopic incisions are used for operating instruments. The esophageal – stomach junction is realigned by rolling the redundant fundus of the stomach around the lower esophagus. If a hiatal hernia is present it is also repaired at this time.
Surgery requires general anesthesia and takes
about two hours. Most all patients spend one night in the hospital
and return to their normal routine in about one week. The results
from surgery are outstanding with an over 90% improvement in symptoms
ten years later. When compared with long term medication, surgery
improves patients’ individual quality of life and overall satisfaction.
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