Nissen Fundoplication
"This Surgery Could Cure your GERD"

Table of Contents
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Nissen Fundoplication - Overview

The procedure known as the "Nissen Fundoplication" is the gold standard surgery for GERD; it was designed to accomplishes two goals:

1. Correct a herniated diaphragm (sliding hiatus hernia).
2. Reinforce and strengthen the lower esophageal sphincter (LES).

Simply stated, gastroesophageal reflux disease (GERD) is the result of acid backing up into the esophagus (food pipe) and attacking its lining.

Therefore, accomplishing the following will permanently cure GERD:

• Restoring the LES to its full functionality, which is to prevent digestive acid escaping upwards during and after the swallowing action.
• Eliminating trigger foods together with a number of substances and drugs.
• Adopting certain lifestyle changes.

For many patients, Mother Nature will automatically strengthen the LES with the help of dietary and lifestyle changes, however, this doesn’t work for everyone.

Since some GERD sufferers also have a hiatus hernia, they have no choice other than to resort to surgery when all else fails.

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How is a Nissen Fundoplication Carried Out?

This procedure is usually done through Laparoscopic surgery (also known as videoscopic or keyhole surgery).

A small incision is made, either in the abdomen or the lower chest, and the surgeon performs the procedure using specially designed instruments with the help of a laparoscope.

A laparoscope is a fiber-optic instrument that transmits images from inside the body to a video monitor.

During surgery the upper curve of the stomach, called the ‘upper fundis’, is wrapped tightly around the LES and secured with sutures.

This flexible tissue acts as a giant rubber band that keeps the LES tightly closed when not in use, while at the same time, allowing enough flexibility for food to pass into the stomach during the natural swallowing action.

If laparoscopic surgery is used, you will only be hospitalized for a couple of days and you’ll be able to resume normal activity within in a week or two.

On the other hand, with traditional "open" surgery, you will be hospitalized for five or six days, followed by a lengthy recuperative period.

When opting for the laparoscopic variety, selecting an experienced surgeon with a high success rate is absolutely essential.

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How Successful is it?

Studies show that by using minimally invasive laparoscopic surgery, the success rate for patients who have typical GERD symptoms is 90 to 95 percent.

However:

• There have been no studies done that prove that this surgery is effective in maintaining esophageal healing in the long term (see Barrett's Esophagus).
• The surgery does not guarantee that GERD symptoms will never return.

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What are the Risks?

If the upper fundis is wrapped too tightly around the LES, the following conditions could develop:

1. Intestinal gas and the inability to burp.
2. Bloated stomach.
3. Inability to vomit.
4. Difficulty in swallowing.

These conditions could persist for up to six months.

In addition to that:

• Heartburn episodes may return.
• There is an outside chance of upward pressure forcing the fundis off the LES if it is not wrapped tightly enough. This can be exacerbated if the patient indulges in overeating.
• Normal risks associated with anesthesia, infection and bleeding.

On the bright side, there's an excellent chance that the treatment will succeed. If so, you’ll be able too say ‘goodbye’ to pain and all those expensive and harmful Proton Pump Inhibitors, H2 blockers and

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Breaking News

EsophyX TIF Natural Orifice GERD Surgery

EndoGastric Solutions (opens new window), the world leader in natural orifice surgery products and procedures, has developed a non-invasive, Transoral Incisionless Fundoplication (TIF ) procedure.

This new surgery mimics the outcomes of the more invasive gold-standard Nissen fundoplication procedure.

Dr. John Hunter, Professor and Chairman of the Department of Surgery at Oregon Health & Science University in Portland, Oregon, states, "For years, the medical community has been looking for less invasive ways to treat GERD patients to reduce their dependence on pharmaceuticals.

Our department has studied the effects of these pharmaceuticals and is concerned that there are additional detrimental effects that should be avoided. EsophyX is an impressive technology with impressive results that advances the treatment of GERD a giant leap forward."

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Linx' Technology

Torax Medical Inc. (opens new window) of Albany, GA, recently announced an exciting medical breakthrough called 'Linx' Technology designed to make the Nissen Fundoplication procedure obsolete.

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