Keyhole surgery
Laparoscopic fundoplication for reflux
Keyhole surgery for acid reflux that has not settled on medication — the top of the stomach is wrapped around the lower food pipe to restore the valve effect.
In plain language
What this operation is
Reflux happens when the valve between the food pipe and the stomach does not close properly, so stomach acid travels upward. That causes heartburn, an acid taste, a cough at night, or pain behind the breastbone.
Most people are treated with medication and changes to diet and habits, and for many that is enough. Surgery is considered when reflux persists despite proper treatment, when medication cannot be continued long term, or when there is a hiatal hernia contributing to it.
In a fundoplication the top of the stomach is wrapped around the lower food pipe and stitched, restoring the valve mechanism. It is done through small ports.
Who it is for
When this operation is advised
- Reflux that continues despite adequate medical treatment
- Reliance on acid-suppressing medication over a long period
- A hiatal hernia contributing to the reflux
- Complications of reflux found on endoscopy
And when it is not. Surgery is not the first step for reflux. Medication, diet and habit changes come first, and for most people they are sufficient.
How it works
From assessment to follow-up
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01
Investigation
Endoscopy is usually needed, and sometimes tests of food-pipe pressure and acid exposure. These decide whether surgery is appropriate.
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02
Deciding
The discussion covers what surgery can and cannot change, and what side effects are possible.
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03
The operation
Under general anaesthesia, through small ports. Any hiatal hernia is repaired and the wrap is created.
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04
Afterwards
A staged diet — liquids, then soft food, then normal — following the plan given at discharge.
Afterwards
What recovery involves
Recovery differs between patients. What follows is what usually happens — your own timeframe is given at discharge, based on the operation you actually had.
- A staged return to normal food is expected, not immediate.
- Difficulty swallowing in the early weeks is common and usually settles as the swelling reduces.
- Some people find they burp less easily afterwards. This is a known effect of the wrap.
- Whether acid-suppressing medication can be stopped is decided at follow-up, not assumed.
When to go to hospital instead
Chest pain that is severe or new, or vomiting blood, is not something to investigate at a chamber appointment. Go to a hospital.
Common questions
Questions patients ask
Anything not covered here can be answered at the consultation.
01 Will I be able to stop my reflux medicine after surgery?
Many people reduce or stop it, but that is not guaranteed and it is decided at follow-up rather than promised beforehand. The purpose of the operation is to correct the mechanism, not to make a promise about tablets.
Medication02 Is difficulty swallowing after the operation normal?
Some difficulty in the early weeks is expected while swelling settles, which is why the diet is staged. Difficulty that persists should be reported at follow-up.
After surgery03 Is surgery the first treatment for reflux?
No. Medication, diet and habit changes come first, and for most people they work. Surgery is considered when reflux persists despite proper treatment or cannot be controlled long term.
WhenNext step
Bring your reports to a consultation
Often one visit is enough to know whether an operation is needed at all.