Reflux surgery (fundoplication) is a surgical procedure at the lower end of the oesophagus and at its junction with the stomach. This is intended to prevent the return of stomach contents back into the esophagus. Over a long period of time, reflux can cause inflammation of the oesophageal mucosa and secondary diseases.
In this article, you can find out how reflux surgery works and where you can find specialists for reflux surgery.
Reflux from the stomach into the oesophagus is a problem for many people in the industrialized world. The associated symptom is also known as heartburn.
Reflux occurs when the sphincter muscle between the stomach and esophagus does not function properly @ AntonioDiaz /AdobeStock
A change in eating habits and medication (proton pump inhibitors (PPI)) can reduce acid production in the stomach.
This can prevent the reflux of stomach contents into the oesophagus in most cases . If this is not successful, the doctor will recommend reflux surgery.
During reflux surgery, a fundus sleeve at the lower end of the oesophagus prevents the chyme from flowing back.
Reflux surgery (fundoplication) is mainly performed as keyhole surgery (laparoscopic) using an endoscope.
This has several advantages for the patient, such as
Doctors usually apply a full Nissen-Rosetti cuff during reflux surgery. However, operations with partial cuffs have also become more common in recent years (reflux surgery according to Toupet). In this procedure, doctors apply a cuff that covers the entire oesophagus.
Nissen reflux surgery is the standard surgical procedure for preventing reflux @ Pepermpron /AdobeStock
In the Toupet procedure, the sleeve is not completely around the oesophagus, but is attached to the front. Toupet surgery is used more frequently in people with certain pre-existing conditions, such as diabetics.
Reflux surgery is useful for patients who do not respond to conventional therapy (medication).
In the case of a hiatal hernia (diaphragmatic hernia), the procedure can also be useful together with a hiatoplasty.
As with any surgical procedure, reflux surgery also involves certain risks and side effects.
The most common are
Reflux surgery is a successful method of permanently curing reflux disease. According to a study, it is more successful in the long term than drug therapy.
For younger patients, reflux surgery has a cost advantage over long-term (permanent) medication. Around 90% of reflux surgery patients no longer have reflux or heartburn after the procedure.
In 8% of patients, reflux surgery is unsuccessful. In these cases, the cuff cannot stop the reflux.
Despite successful reflux surgery, it is not uncommon for patients to complain about the after-effects of the procedure, such as
The chances of success are greatest in specialized clinics for visceral surgery. Experts in reflux surgery work there. They representspecialist areas of internal medicine, gastroenterology, visceral surgery and nutritional medicine.
You should have the operation performed at a designated center for visceral surgery, as quality standards and a sufficiently high level of experience are available.
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