If you suffer from moderate to severe “heartburn” your surgeon may have recommended Laparoscopic Antireflux Surgery to treat this condition, technically referred to as gastroesophageal reflux disease (GERD). This brochure will explain to you:
What gastroesophageal reflux disease (GERD) is
Medical and surgical treatment options for GERD
How this surgery is performed
What to expect if you choose to have laparoscopic anti-reflux surgery
What is Gastroesophageal Reflux Disease (GERD)?
Gastroesophageal Reflux Disease (GERD) is digestive problems that occurs when acidic stomach juices, or food and fluids back up from the stomach into the esophagus. GERD affects people of all ages—from infants to older adults. The feeling may indicate through the chest and into the throat and neck Although the name “heartburn” is often used in medical terms, it is actually a symptom of gastroesophageal reflux disease. Some symptoms may also include vomiting, difficulty in swallowing, and chronic coughing.
WHAT CAUSES GERD?
GERD occurs commonly in people who are:
overweight or obese because of increased pressure on the abdomen of the body
due to certain medications, including some asthma drugs, calcium channel blockers, antihistamines, sedatives
The lower esophageal sphincter (LES) is a circular band of muscle at the end of your esophagus. When it’s working properly, it relaxes and opens when you swallow. Then it tightens and closes again afterward.
WHAT CONTRIBUTES TO GERD?
Some people are born with a naturally weak sphincter (LES). For others, however, fatty and spicy foods, certain types of medication, tight clothing, smoking, drinking alcohol, vigorous exercise or changes in body position (bending over or lying down) may cause the LES to relax, causing reflux. A hiatal hernia is found in many patients who suffer from GERD. This refers to the condition in which the top part of the stomach bulges above the diaphragm and into the chest cavity. This phenomenon is thought to contribute to the development of acid reflux. Surgery for GERD also fixes the hiatal hernia.
Medical and Surgical Treatment Options
GERD is generally treated in three progressive steps: 1. LIFESTYLE CHANGES In many cases, changing diet and taking over-the-counter antacids can reduce how often and how harsh your symptoms are. Losing weight, reducing or eliminating smoking and alcohol consumption, and altering eating and sleeping patterns can also help.
2. DRUG THERAPY If symptoms persist after these lifestyle changes, drug therapy may be required. Antacids neutralize stomach acids and over-the-counter medications reduce the amount of stomach acid produced. Both may be effective in relieving symptoms. Prescription drugs may be more effective in healing irritation of the esophagus and relieving symptoms. This therapy needs to be discussed with your primary care provider and your surgeon.
3. SURGERY Patients who do not respond well to lifestyle changes or medications or those who do not wish to continually require medications to control their symptoms may consider undergoing a surgical procedure. Surgery is very effective in treating GERD. The most commonly performed operation for GERD is called a fundoplication (usually a Nissen fundoplication, named for the surgeon who first described this procedure in the late 1950s). A fundoplication involves fixing your hiatal hernia, if present, and wrapping the top part of the stomach around the end of the esophagus to reinforce the lower esophageal sphincter, and thus recreates the “one-way valve” that is meant to prevent acid reflux. This can be done using a single long incision on the upper abdomen, or more commonly by minimally invasive techniques using several small incisions, called laparoscopic surgery.
WHAT ARE THE ADVANTAGES OF THE LAPAROSCOPIC METHOD?
The advantage of the laparoscopic approach is that it usually provides:
reduced postoperative pain
shorter hospital stay
a faster return to work
improved cosmetic result
ARE YOU A CANDIDATE FOR THE LAPAROSCOPIC METHOD?
Although laparoscopic anti-reflux surgery has many benefits, it may not be appropriate for some patients. Obtain a thorough medical evaluation by a surgeon qualified in laparoscopic anti-reflux surgery in consultation with your primary care physician or Gastroenterologist to find out if the technique is appropriate for you.
How the Surgery is Performed
WHAT TO EXPECT BEFORE LAPAROSCOPIC ANTI-REFLUX SURGERY?
After your surgeon reviews with you the potential risks and benefits of the operation, you will need to provide written consent for surgery.
Preoperative preparation includes blood work, medical evaluation, chest x-ray, and an EKG depending on your age and medical condition.
Additional test may be needed prior to surgery, which will be ordered by your surgeon based on your individual history
It is recommended that you shower the night before or the morning of the operation.
After midnight the night before the operation, you should not eat or drink anything except medications that your surgeon has told you are permissible to take with a sip of water the morning of surgery.
Drugs such as aspirin, blood thinners, anti-inflammatory medications (arthritis medications), and Vitamin E will need to be stopped temporarily for several days to a week prior to surgery.
Diet medication or St. John’s Wort should not be used for the two weeks prior to surgery.
Quit smoking and arrange for any help you may need at home.