Cardiovascular and Thoracic Surgery

Gastroesophageal Reflux Disease (GERD)

Gastroesophageal reflux disease (GERD) is a chronic digestive disease that occurs when stomach acid or, occasionally, bile flows back (refluxes) into your food pipe (esophagus). The backwash of acid irritates the lining of your esophagus and causes GERD signs and symptoms.

Symptoms

Heartburn, also called acid indigestion, is the most common symptom of GERD.

Treatment

If diet changes and medication are not having any effect on heartburn and regurgitation, you may be a candidate for minimally invasive surgery to strengthen the lower esophageal sphincter, the muscle that opens and closes to let food pass from the esophagus to the stomach.

Laparoscopic anti-reflux surgery is a minimally-invasive procedure that corrects gastroesophageal reflux by reducing the hiatal hernia, reconstructing the esophageal hiatus and reinforcing the lower esophageal sphincter.

During laparoscopy, five or six small punctures are made in the abdomen permitting insertion of a telescope for viewing and instruments to do the operation. This can be accomplished in some patients on an outpatient basis or with just one overnight stay in the hospital. If laparoscopy is not feasible, the operation is performed through an open abdominal incision or an incision on the left side of the chest. These larger operations require a hospital stay of at least several days.

The aims of surgery for GERD are to correct any hernia which might exist and to wrap a portion of the stomach around the esophagus, thus creating a new valve mechanism to prevent reflux. If complications of GERD exist, such as scarring or ulcer formation, these are also corrected at the same time. The likelihood of having a successful operation that relieves symptoms of GERD sufficiently so that no medications are necessary is about 95%.

Patients who have laparoscopic anti-reflux surgery generally experience less pain and scarring after surgery, have a quicker recovery, and less risk of infection than those who have traditional anti-reflux surgery.

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