Nissen Fundoplication is a surgical solution for severe heartburn, acid reflux, or Gastro-Esophageal Reflux Disease. Heartburn develops when the valve between the esophagus and the stomach stops working the way that it should. This allows acid from your stomach to reflux backward, into your esophagus. The esophagus does not have the acid resistant protective lining that your stomach does, so the reflux of acid causes irritation. Because of this, the acid causes pain that we sense in the upper portion of our stomach or underneath our breastbone.
There are two ways to treat heartburn:
- Decrease the acidity of the stomach so that the refluxed contents do not burn the esophagus. This works well in all but the most severe cases. In severe cases of Gastro-Esophageal Reflux Disease (GERD), there is so much refluxed fluid that even if you reduce the acid content, other substances in the stomach fluid will still irritate the esophagus.
- Repair the Valve – Surgery is clearly the best way to repair the valve. There is a complex anatomic relationship between your diaphragm, esophagus and stomach that can be restored by performing a Nissen Fundoplication.
A Nissen Fundoplication works in three ways.
- It restores the angle between the stomach and esophagus which helps to restore the valve function
- It repairs a hiatal hernia in which the stomach pooches up into your chest by tightening the diaphragm and pulling the stomach down from the chest
- It creates a new valve by wrapping the stomach around itself and suturing it in place
A Nissen Fundoplication can be performed laparoscopically and requires an overnight stay in the hospital and typically a week off of work.
Candidates that meet these criteria should be evaluated for the surgery
- You have discomfort from Heartburn on a daily basis, despite treatment with acid reducing medications
- You are not obese (your BMI is less than 35 – Check your BMI here)
- You obtain some relief from your acid blocking medication
Evaluation before surgery requires an Upper GI Barium Swallow and an upper endoscopy procedure. Some patients may also benefit from a pH study of the esophagus and occasionally a pressure (manometry) test
If you think that you may be a candidate for a Nissen Fundoplication, contact our office at: (248) 413-2670 or fill out the form to the right.