| Stomach-wrapping Surgery Offers GERD Sufferers Hope |
| Written by Helen White | |
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Gastroesophageal reflux disease, in many cases, can be resolved by dietary and lifestyle changes, but in some cases more aggressive measures are called for. A common surgical procedure used to treat GERD is Nissen fundoplication.
Nissen fundoplication is considered by medical professionals to be one of the safest and most effective forms of surgical treatment to take care of GERD. The mortality rate is less than one percent, and tracking studies have shown that 10 years after the procedure, nearly 90 percent of all patients remain symptom-free. The Nissen fundoplication, first known as gastroplication, was first performed in 1955 by Dr. Rudolph Nissen, who published the results of the procedure in an issue of Swiss Medical Weekly later the next year. Nissen published more material concerning the procedure in 1961, and through the decade of the 1970s the procedure gained in popularity. GERD is caused by a weakness of the esophaegal sphincter which allows stomach acid to reflux into the esophagus, causing severe irritation and discomfort. If left untreated, GERD can result in a number of other illnesses, including esophaegal ulcers and bleeding. Also, recent studies have shown a link between GERD and esophaegal cancer. Nearly 16,000 Americans died of esophaegal cancer last year. In the procedure, a doctor strengthens the esophaegal sphincter by wrapping the gastric fundus, a part of the patient's stomach, around the lower portion of the patient's esophagus. This procedure will help keep stomach acid from flowing into the esophagus and also helps the esophaegal sphincter to function properly. The procedure can be done as an open surgery, but a laparoscopic technique is becoming increasingly popular and accepted. In the laparoscopic version of the procedure, the surgeon uses small surgical tools and a small video tube inserted through a tiny incision into the abdomen to perform the surgery. The laparoscopic version is less invasive than the traditional version which requires surgeons to open up the patient with a large incision. There's also a quicker recovery time from the laparoscopic version. The laparosocpic option only requires a one-day stay at the hospital, as opposed to the week-long stay required for open surgery. Most patients will be fully recovered from the surgery within two weeks, as opposed to four to six weeks in open surgery. The average cost of Nissen fundoplication is about $7,000, but most insurance policies do afford coverage for the procedure. After your surgery, you'll need to change how you eat for awhile. You'll need to eat soft foods while the surgery heals, and you'll also need to chew thoroughly and swallow slowly to keep from overloading your healing esophagus. While the procedure is successful for nearly nine in 10 patients, there may be some complications from the operation, however. Gas bloat syndrome is one complication of Nissen fundoplication that can render patients unable to belch. This can result in a build up of gas in the patient's stomach or small intestine, resulting in discomfort. The gas may be caused by the patient's diet, especially if he or she consumes carbonated beverages. About two to five percent of Nissen fundoplication patients report this complication, but in most cases it resolves itself after two weeks to a month. Occasionally, the Nissen fundoplication can unwrap. This occurs in about five to 10 percent of cases. This can be treated by redoing the operation and using an artificial mesh to support the wrap. Some patients will report that the procedure has left them unable to vomit, but over time as the wrap settles they should be able to vomit. The surgery may not rid you of all symptoms of GERD, but most people who have the surgery report a marked reduction in symptoms and are able to decrease the level of medication they need to take to manage GERD. For many GERD sufferers, Nissen fundoplication is a godsend, allowing them to mitigate or eliminate their symptoms and enjoy life without the constant discomfort and irritation caused by gastroesophageal reflux disease. When considering the surgery, patients and their health care providers should consider the potential benefits and risks of the procedure and any existing health problems you have that may have an impact on the safety or success of the procedure. Like all surgical procedures, there is a level of risk associated with Nissen fundoplication, and your health care provider is better able to assess that risk if he or she is apprised of all relevant health information, so take care to be forthright and thorough in describing your general health and GERD symptoms. |
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