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Fundoplication

Discussion in 'All Categories' started by Amrit - Jul 16th, 2025 7:05 am.
Amrit	Why is Nissen fundoplication done and what are the complications?
re: Fundoplication by Dr. B. S. Bhalla - Jul 16th, 2025 7:06 am #1
Dr. B. S. Bhalla	Nissen fundoplication is a surgical procedure primarily performed to treat gastroesophageal reflux disease (GERD) and hiatal hernia. GERD occurs when the lower esophageal sphincter (LES) fails to close properly, allowing stomach acid to flow back into the esophagus, causing heartburn, regurgitation, and inflammation. When lifestyle changes and medications like proton pump inhibitors fail to control symptoms, Nissen fundoplication is considered. In this procedure, the top portion of the stomach (the fundus) is wrapped 360 degrees around the lower esophagus. This reinforcement of the LES acts as a physical barrier, preventing acid reflux. It is also performed to repair hiatal hernias and, occasionally, in patients with severe esophageal motility disorders. Complications can occur, though they are relatively rare with experienced surgical hands. These include: Dysphagia (difficulty swallowing): Common in the early postoperative period. Usually resolves but may persist if the wrap is too tight. Gas-bloat syndrome: Patients may find it difficult to burp or vomit, leading to bloating and discomfort. Esophageal injury or perforation: A rare but serious complication. Wrap migration or herniation: The wrap can slip, leading to recurrent symptoms. Infection or bleeding: As with any surgery. Anesthesia-related risks: Especially in elderly or high-risk patients. Recurrence of GERD symptoms: Can happen in the long term if the wrap loosens. Overall, Nissen fundoplication is highly effective for controlling reflux symptoms and improving quality of life in appropriately selected patients. A thorough preoperative evaluation including pH monitoring, endoscopy, and manometry is essential for surgical planning and optimal outcomes. Post-surgery, patients are advised to follow a soft diet, avoid carbonated drinks, and follow up regularly with their surgeon or gastroenterologist.