Reflux Surgery
What is acid reflux?
Acid reflux is a condition where acid from your stomach travels up into your oesophagus. This happens if the valve between your stomach and your oesophagus does not work effectively. Acid reflux can cause ‘heartburn’ or acid in the back of your mouth. The procedure involves ensuring the stomach remains inside your abdomen, instead of your chest with or without a stomach fundoplication “wrap”.
Acid reflux can cause heartburn or acid in your mouth. The acid can cause the lining of your oesophagus to become inflamed or scarred. Surgery may be recommended if your symptoms continue while you are taking medication.
What does the surgery involve?
The operation is performed under a general anaesthetic and usually takes one to two hours. Your surgeon will insert surgical instruments, along with a telescope, inside your abdomen and perform the operation.
The operation involves returning your stomach into the abdomen and ensuring at least 2cm of your Oesphagus is in the abdomen. Next, your surgeon will stitch your diaphragm to reduce the size of the hole your Oesophagus passes through. Finally, the surgeon will wrap and stitch the top part of your stomach around your lower Oesophagus. The degree of wrap i.e. 90, 180, 270, or 360 degrees will be determined before your operation. It is very important to identify and preserve the anterior and posterior vagus nerves during this operation.
It is also important to preserve the lining of the crural muscles, this gives strength to the repair when the muscles are tightened together.
There are many different types of repairs and some require mesh whilst others don’t. The mesh used can be permanent mesh (lasts forever) or biological mesh that will absorb with time.
How soon will I recover?
You should be able to go home within a few days. You must adhere to a specialised diet that has a soft puree consistency for roughly 4 weeks.
You should be able to return to work after 3 -4 weeks, depending on how much surgery you need and your type of work. It is important to avoid heavy lifting while you recover.
The dressings covering your keyhole incisions can be removed 1 week after surgery and you can shower normally as these dressings are waterproof.
What are the benefits of reflux surgery?
— You should get relief from the symptoms of acid reflux without needing to take medication.
What complications can happen?
— Pneumothorax
— Injury to the anterior or posterior vagus nerves
— Making a hole in your oesophagus or stomach
— Continued difficulty swallowing
— Weight loss
— Abdominal discomfort
— Bloating
— DVT/PE
— Unable to belch.
What are the important tests needed before surgery?
Before performing anti-reflux surgery it may be necessary to undergo a number of different tests. These can include a gastroscopy i.e. an endoscopy looking at your oesphagus and stomach, pH studies to confirm the diagnosis and assess the severity of disease and oesphageal manometry assessing your oesphageal function. All this information may be necessary to ensure the most suitable procedure is performed for you.
What do I eat after surgery?
After hiatus hernia surgery you will need to remain on fluids for a week and slowly progress to puree consistency of food then to a soft diet when you are more comfortable. This diet progression can extend over 4-6 weeks and the hospital dietitian will remind you about this process prior to your discharge home.
It is important to avoid certain foods such as hard cheese, plain bread, crackers, course/dry cereals, hard fibrous fruits or vegetables and tough meats during this recovery period. It is also advised to avoid fizzy drinks.
You will however be able to enjoy a full diet once you have fully recovered from the surgery.
What is acid reflux?
Acid reflux is a condition where acid from your stomach travels up into your oesophagus. This happens if the valve between your stomach and your oesophagus does not work effectively. Acid reflux can cause ‘heartburn’ or acid in the back of your mouth. The procedure involves ensuring the stomach remains inside your abdomen, instead of your chest with or without a stomach fundoplication “wrap”.
Acid reflux can cause heartburn or acid in your mouth. The acid can cause the lining of your oesophagus to become inflamed or scarred. Surgery may be recommended if your symptoms continue while you are taking medication.
What does the surgery involve?
The operation is performed under a general anaesthetic and usually takes one to two hours. Your surgeon will insert surgical instruments, along with a telescope, inside your abdomen and perform the operation.
The operation involves returning your stomach into the abdomen and ensuring at least 2cm of your Oesphagus is in the abdomen. Next, your surgeon will stitch your diaphragm to reduce the size of the hole your Oesophagus passes through. Finally, the surgeon will wrap and stitch the top part of your stomach around your lower Oesophagus. The degree of wrap i.e. 90, 180, 270, or 360 degrees will be determined before your operation. It is very important to identify and preserve the anterior and posterior vagus nerves during this operation.
It is also important to preserve the lining of the crural muscles, this gives strength to the repair when the muscles are tightened together.
There are many different types of repairs and some require mesh whilst others don’t. The mesh used can be permanent mesh (lasts forever) or biological mesh that will absorb with time.
How soon will I recover?
You should be able to go home within a few days. You must adhere to a specialised diet that has a soft puree consistency for roughly 4 weeks.
You should be able to return to work after 3 -4 weeks, depending on how much surgery you need and your type of work. It is important to avoid heavy lifting while you recover.
The dressings covering your keyhole incisions can be removed 1 week after surgery and you can shower normally as these dressings are waterproof.
What are the benefits of reflux surgery?
— You should get relief from the symptoms of acid reflux without needing to take medication.
What complications can happen?
— Pneumothorax
— Injury to the anterior or posterior vagus nerves
— Making a hole in your oesophagus or stomach
— Continued difficulty swallowing
— Weight loss
— Abdominal discomfort
— Bloating
— DVT/PE
— Unable to belch.
What are the important tests needed before surgery?
Before performing anti-reflux surgery it may be necessary to undergo a number of different tests. These can include a gastroscopy i.e. an endoscopy looking at your oesphagus and stomach, pH studies to confirm the diagnosis and assess the severity of disease and oesphageal manometry assessing your oesphageal function. All this information may be necessary to ensure the most suitable procedure is performed for you.
What do I eat after surgery?
After hiatus hernia surgery you will need to remain on fluids for a week and slowly progress to puree consistency of food then to a soft diet when you are more comfortable. This diet progression can extend over 4-6 weeks and the hospital dietitian will remind you about this process prior to your discharge home.
It is important to avoid certain foods such as hard cheese, plain bread, crackers, course/dry cereals, hard fibrous fruits or vegetables, and tough meats during this recovery period. It is also advised to avoid fizzy drinks.
You will however be able to enjoy a full diet once you have fully recovered from the surgery.