fundoplikasi

Fundoplication is a surgical procedure to treat gastroesophageal reflux disease (GERD) and hiatal hernia by reinforcing the gastroesophageal junction. The operation typically uses the upper part of the stomach (the fundus) to wrap around the distal esophagus, augmenting the lower esophageal sphincter and preventing reflux. It is usually performed laparoscopically.

Indications include refractory GERD despite optimized medical therapy, erosive esophagitis, Barrett's esophagus with reflux, and paraesophageal hernia with reflux. Patients who wish to discontinue or reduce acid-suppressive medications or who have intolerance to long-term proton pump inhibitors are common candidates.

Several forms exist, the most common being Nissen fundoplication (360-degree wrap). Other options include Toupet (270-degree partial posterior wrap) and Dor (180-degree anterior wrap). The fundus is mobilized, wrapped around the esophagus, and secured with sutures; hiatus repair may accompany the wrap. Most procedures are laparoscopic; open or robotic approaches are used selectively.

Outcomes vary; many patients experience durable relief of reflux and reduced dependence on medications, with high satisfaction rates. Potential complications include transient or persistent dysphagia, gas bloat syndrome, inability to belch or vomit, wrap herniation or obstruction, and standard surgical risks such as infection or injury to nearby structures.

Postoperative recovery involves diet progression and activity guidance, with follow-up to assess symptom control. Alternatives to fundoplication include continued medical therapy, LINX device, endoscopic procedures such as transoral incisionless fundoplication (TIF), and Stretta radiofrequency therapy.