Acid Reflux Surgery
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Acid Reflux Surgery
If you suffer frequent attacks of acid reflux, you may be suffering from gastroesophageal reflux disease (GERD) which, if left untreated, can lead to serious problems such as esophogeal ulcers and bleeding, or even cancer of the esophagus. If you experience coughing, aspiration or hoarseness together with
, these may be symptoms of GERD.
The disease is not generally caused
by eating the wrong types of food. Rather, it is due to weakness in the muscle of the valve which separates the esophagus from the stomach (the LES). GERD sufferes therefore do not usually get better, and typically have to resort to lifelong medication. While conservative treatment is usually the first course of action, there are also surgical procedures which can be offer a more long-lasting solution.
One of these procedures is fundoplication which is aimed at correcting gastresophageal reflux by creating a new functional lower esophageal sphincter (LES).
Fundo refers to the part of the stomach that is closest to the opening of the esophagus, and plication means the gathering and suturing of one tissue to another. This involves a minimally invasive surgical procedure to tighten the valve between the stomach and the esophagus. If, as is often the case, a GERD sufferer also has a hiatus hernia, this can be corrected during the same procedure.
Patients who have undergone fundoplication, the success rate of whic is said to be 96%, may no longer require medication and may be free of further reflux symptoms.
Fundoplication can be performed by either traditional open surgery or laparoscopically.
The disadvantages of traditional surgery are that it is invasive and may leave scarring, and that the patient must spend 7 – 10 days in hospital, followed by a 4 – 6 week recovery period.
Laparoscopic Procedures to Reduce Acid Reflux
A laparoscopic procedure is done through very small incisions, and utilises new technology and highly specialized instruments. It requires only 1 – 2 days in hospital, with a one week recovery period.
One of the most popular alternatives to traditional surgery is the Nissen fundoplication, in which a portion of the stomach gets completely wrapped around the esophagus. This helps to increase the pressure at the lower end of the esophagus and strengthen the muscular valve between the esophagus and the stomach, thus preventing the acid from leaking back from the stomach into the esophagus.
Another option is EsophyxX TIF (Transoral Incisionless Fundoplication), which is similar to the procedure described above.
Endoscopic Procedure to Treat Acid Reflux
A more recent approach is the SRS endoscopic system developed by Medigus, which has the following principal advantages:
It provides the same results as laparoscopic surgery.
It takes less time than laparoscopic surgery.
It offers a more appealing treatment than either surgery or lifelong medication.
It is more efficient and cost effective.
Since there are no incisions, it causes less trauma to the patient.
Is there a downside to fundoplication procedures?
Although laparoscopic and endoscopic procedures may seem to offer a preferable option to traditional open surgery, people who are considering them should consider the possible after-effects.
One patient who underwent the EsphyxX procedure reported vomiting during recovery, with spasms every few minutes for the first week. She was on clear liquids for 5 days before and 2 days after surgery, and full liquid the following week. She was able to eat soft foods two weeks after the procedure, but experienced a feeling of fullness which made her unable to eat more than a little of any food. After three weeks, she still experienced burping and gas, with morning nausea almost daily.
The feeling of fullness which this patient experienced is apparently due to swelling, and diminishes as the swelling goes down.
After the Nissen surgery, a patient reported the same feeling of fullness, and said that it was several months before she got back to normal.
Another device and treatment for GERD was approved by the U.S. Food and Drug Administration (FDA) on March 22, 2012 makes use of a band of magnetic beads made of permanent rare earth magnets encased in titanium.
The band is fitted during a minimally-invasive surgical procedure lasting about 20-30 minutes. It is made up of a series of magnetic beads, and is secured around the base of the esophagus. The magnetic attraction between the beads supports the valve to protect the esophagus from reflux. The band opens to allow food to pass during swallowing, or to release gas, but prevents the reflux of acid.
According to experts, this device can correct the cause of acid reflux itself by restoring the body\’s physiological barrier.
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