For patients who suffer from heartburn that is not well controlled with medications or if they wish to get off medications, anti-reflux surgery should be considered. The most common procedure is called fundoplication and consists of surgically building a valve between the stomach and the esophagus using a part of the upper stomach called the fundus.
There are two types of fundoplications: complete and partial.
With complete or 360-degree fundoplication, also called Nissen fundoplication, the upper part of the stomach or fundus is fully wrapped around the lower esophagus to strengthen the muscle and prevent stomach acid from flowing back into the esophagus.
On the other hand, a partial fundoplication only partially wraps the upper part of the stomach or fundus around the lower esophagus. This may be done in various configurations that bring the upper stomach in front or behind the lower esophagus and each configuration has a name such as Toupet, Watson, Dor, etc. Partial fundoplication has been shown in recent studies to be as effective long term at controlling acid reflux but has lower side effects such as less difficulty swallowing.
In our practice, we favor partial fundoplication in most patients. We will discuss however doing your consultation the best procedure for you based on various factors including your symptoms, the results of your tests, the function of your esophagus, etc.
These procedures are all done laparoscopically or robotically with usually an overnight hospital stay, a fast recovery and a quick return to work and normal activities.
If you have severe heartburn or GERD and are considering a fundoplication procedure, schedule a consultation with us to determine if this is a good option for you.