Fundoplicatio

Fundoplicatio is a surgical procedure primarily used to treat gastroesophageal reflux disease (GERD), a condition where stomach acid frequently flows back into the esophagus, causing irritation and potential complications. The procedure involves wrapping part of the stomach around the lower esophageal sphincter (LES), reinforcing its function to prevent acid reflux. This technique is often referred to as a Nissen fundoplication when a 360-degree wrap is performed, though variations exist depending on the patient’s needs.

The most common form of fundoplication is the Nissen procedure, where the upper portion of the stomach (the fundus) is wrapped around the distal esophagus and secured. This creates a mechanical barrier that strengthens the LES, reducing or eliminating acid reflux. Partial wraps, such as the Toupet or Dor fundoplication, may be used in cases where a full wrap is not suitable, such as in patients with significant esophageal motility issues.

Fundoplicatio is typically performed laparoscopically, a minimally invasive technique that reduces recovery time and complications compared to open surgery. Candidates for the procedure usually include patients with severe GERD who do not respond adequately to medical treatments like proton pump inhibitors or lifestyle modifications. The surgery may also be recommended for those with complications such as esophageal strictures, Barrett’s esophagus, or hiatal hernias.

Recovery from fundoplicatio generally involves a hospital stay of one to three days, followed by a gradual return to normal activities over several weeks. Potential complications include dysphagia (difficulty swallowing), gas bloat syndrome, or recurrence of reflux, though these are relatively rare with proper surgical technique. Long-term success rates are high, with many patients experiencing significant relief from GERD symptoms. However, the procedure is not without risks, and patients should discuss potential benefits and drawbacks with their healthcare provider.