A laparoscopic fundoplication surgery to treat GERD or hiatal hernia is still major surgery and the patient and surgeon should think of it in that light. Only an experienced surgeon who has done many laparoscopic operations should perform it.
After open surgery, you may need 4 to 6 weeks to get back to your normal routine. This care sheet gives you a general idea about how long it will take for you to recover. But each person recovers at a different pace. Follow the steps below to get better as quickly as possible.
Although a Nissen's fundoplication is now usually done by keyhole (laparoscopic) surgery, it is a major operation and your child will need to be in hospital for about 3-5 days.
Complications of fundoplication
The possible complications of any operation include things like infection, bleeding or an unexpected reaction to the anaesthetic. Specific complications of fundoplication include the following. Difficulties with swallowing that continue for longer than normal.
You can expect to go home 1 to 3 days after Nissen fundoplication surgery. If you have open surgery, you might need to stay in hospital for longer.
The capacity of the stomach is decreased slightly and it doesn't distend as much until healing occurs. On average, our patients lose approximately 10% of their weight. For this reason, it is extremely important for patients to understand their protein and caloric needs following surgery.
You should be able to progress to a soft-normal diet 4 – 6 weeks after surgery. What is a soft-normal diet? A soft-normal diet involves gradually introducing more solid textures to your diet. While you are having a soft-normal diet you should avoid the same foods you were advised to avoid on page 4.
Nissen fundoplication not only relieves symptoms of acid reflux, but it can also help prevent future complications—even for patients whose acid reflux symptoms are mostly well managed by medications. Oftentimes, these patients are unaware of the long-term effects of GERD.
Nissen fundoplication
Although this works well to control reflux, it can also cause complications such as bloating and swallowing difficulties, called dysphagia. In some people, these complications persist after surgery.
Laparoscopic fundoplication (LF) is the standard surgical procedure for the treatment of gastro-oesophageal reflux disease (GORD). Laparoscopic Roux-en-Y gastric bypass (LRYGB) is commonly performed to achieve weight loss in obese patients, but it also has anti-reflux properties.
From September 1992 to December 2005, 420 consecutive patients, 171 male and 249 female, mean age 42.8 years (range 12-80) with GERD underwent laparoscopic Nissen-Rossetti fundoplication.
I have found that most of my patients have excellent control of their GERD symptoms with a fundoplication wrap that still allows the majority of them to belch and vomit.
There is usually minimal pain associated with this operation. The abdomen will be sore as well as the small incision sites, and some patients have shoulder pain for the first day or two. The shoulder pain is caused by gas left in your abdomen during the operation. It will disappear on its own.
Avoid any foods that cause stomach gas and distention. These foods include corn, dried beans, peas, lentils, onions, broccoli, cauliflower and any food from the cabbage family. Avoid carbonated drinks, alcohol, citrus and tomato products.
Side effects of Nissen fundoplication such as dysphagia, increased bloating and flatulence, and inability to belch or vomit may limit the success of antireflux surgery[12,13].
It's normal to feel full more quickly than usual after your surgery. This is because your stomach is slightly smaller. Eating or drinking too much at once can cause discomfort. This should slowly get better over about 6 to 8 weeks.
We report an excellent quality of life with a median total score of 70 (range 2–75). Re-operation rate was 13.6% (23/169); the re-operation was due to recurrent reflux in 12 patients and due to persistent dysphagia in 11 patients. 91.3% of the re-operations were performed within the first 5 years after surgery.
Most patients see an improvement in their symptoms after the procedure and no longer require daily medication. Patients who are elderly, have other health problems, or have weak peristalsis (digestive motion) are not good candidates for a Nissen Fundoplication.
Johansson et al4 also reported a 21% dysphagia rate, 18% recurrent reflux rate, and 84% overall success rate for Nissen fundoplication at 5 years' follow-up, whereas Luostarinen et al6 reported an overall success rate of 76% at 20 years' follow-up.
The study cohort included 2655 patients with GERD who had undergone primary laparoscopic antireflux surgery between 2005 and 2014. The sex distribution was even (51.0% men). The median age at surgery was 51.0 years (interquartile range, 40.0-61.0 years).
Eating chocolate can result in the GERD symptoms reappearing and kill the purpose of this surgery. Cocoa in chocolate is acidic in nature, and physicians suggest not eating anything that may cause acidity following the Nissen Fundoplication surgery.
Nissen procedure is associated with some weight loss but not enough when compared to gastric sleeve surgery or gastric bypass procedure.
Shortness of breath may result from a slipped Nissen fundoplication, aka recurrent hiatal hernia. Shortness of breath may be precipitated by a heavy meal or gas accumulation in stomach.
Dumping syndrome may occur when a large volume of gastric content is delivered to the duodenum or jejunum, resulting in both gastrointestinal and vasomotor symptoms. Occasionally, dumping syndrome may be a complication in patients that have undergone nissen Fundoplication, especially in adults.