How to Have Surgery to Treat GERD

Most cases of Gastroesophageal Reflux Disease (GERD) can be managed with a change in diet and lifestyle. However, in other cases, so much damage to the esophagus has occurred that the symptoms experienced can make life very difficult indeed. In fact, these patients may not respond to the usual methods used to treat GERD and surgery must be considered to treat them instead. If you suffer from chronic or advanced GERD, learn how surgery can help.

Instructions

Difficulty: Moderately Challenging

1. Insist that your doctor perform certain tests prior to making a decision about whether you should have surgery to treat GERD. An endoscopy, for example, can help rule out other disorders that may emulate the symptoms of GERD.
2. Make a decision about surgery being right for you. You can assume you are a candidate for surgery to treat GERD if lifestyle modifications and medications have failed to relieve symptoms, or if the cost and difficulty of maintaining medical treatment over the long-term is too challenging.
3. Learn that the surgical procedure to treat GERD is known as fundoplication and has two methods of approach--either 'laparoscopic fundoplication' or 'open Nissen fundoplication.'
4. Know that if a laparoscopic fundoplication (or laparoscopy) is performed, the surgeon will create a series of incisions along the abdomen to access the fundus from which to create a 'collar' to surround the lower esophagus to replace the weakened muscle. The surgeon relies on a miniature camera and instruments inserted through special tubes to avoid direct invasion of the area.
5. Expect more risks from having an open Nissen fundoplication, which is more invasive and usually necessitates a hospital stay of one week to 10 days.
6. Discuss the possibility of having a Toupet or Thal fundoplication with your doctor. These procedures involve only a partial wrap of the fundus around the esophagus and seem to present less long-term complications.

Tips & Warnings

• Have your complete medical history available when you meet with the surgeon to discuss whether or not to have surgery to treat your GERD.
• Review all of your options. There are many less invasive and even non-surgical treatments for chronic GERD available now, such as radiofrequency (Stretta procedure) and dilation techniques.
• There are certain risks associated with the decision to have surgery to treat GERD, such as bloating, permanent difficulty swallowing and respiratory complications. In addition, surgery for GERD has a significant failure rate, from 30 percent just 5 years after surgery to 63 percent after 10 years.
• Hiatal herniation is the leading cause of surgical failure in the treatment of GERD.