The operation, which was performed laparoscopically, is identical to the conventional Nissen fundoplication. There was a mortality rate of 0% and a morbidity rate of 25.7%.
What are the complications of Nissen's fundoplication surgery? The surgery is relatively safe with morbidity of less than 1%. Like any major surgery, fundoplication also has a risk for complications that are usually treatable or transient.
[3] Many studies report good results after Nissen fundoplication with a successful symptomatic outcome in 80%–95% of the patients at a long-term follow-up of up of 5 years.
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.
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.
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.
Complications of NF include dysphagia, diarrhea and flatulence, recurrent heartburn and atypical symptoms. The fundoplication can also come undone over time in about 5 to 10% of cases1.
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.
You will be able to eat your usual amounts of food. How quickly you recover depends on which type of surgery you had. After laparoscopic surgery, most people can go back to work or their normal routine in about 2 to 3 weeks, depending on their work.
Just as other body parts, the fundoplication wrap created during the GERD surgery will slowly loosen over time. Therefore even some patients that originally could not burp or vomit will be able to do so as the wrap loosens.
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.
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.
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.
Another option is transoral incisionless fundoplication (TIF), which is performed with the EsophyX (EndoGastric Solutions) device. An internal fundoplication is created endoscopically and uses transmural fasteners to hold the fundoplication in place.
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.
Caffeine in moderation is OK. Do not drink alcohol for 24 hours after surgery and/or if you are taking opioids.
Postoperative weight gain may lead to fundoplication failure to contain reflux due to the increase in intra-abdominal pressure and modification of the gastroesophageal pressure gradient 14 , 23 . In this case, a new surgery may be necessary to control weight and preserve the anti-reflux mechanism.
The surgeon is guided by images transmitted from a lighted camera in the laparoscope inserted through one of the incisions. Laparoscopic Nissen fundoplication is performed under general anesthesia in an operation room. The procedure may take up to three hours.
The fundoplication can also come undone over time in about 5–10% of cases, leading to recurrence of symptoms.
Anti-reflux surgery is safe, and it works. After your surgery, you should have fewer problems with heartburn. But if that burning feeling creeps back up again, you might need to have a repeat surgery. To avoid another procedure, take your heartburn medicine if you need it.
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.
Take small bites and chew your food well to help aid in swallowing and digestion. Avoid crusty breads and sticky, gummy foods, such as bananas, fresh doughy breads, rolls and doughnuts. These types of foods become sticky and difficult to swallow. Toasted breads tend to be better tolerated.
Treating GERD and hiatal hernias with minimally invasive surgery. Nissen fundoplication is a surgical procedure used to treat gastroesophageal reflux disease, or GERD, and hiatal hernia. It tightens and reinforces the sphincter at the top of the stomach to prevent stomach acid from rising into the esophagus.