Nissen Fundoplication

Nissen Fundoplication is a surgery in which a sphincter at the bottom of the esophagus is created by a surgeon to prevent acid reflux to treat gastroesophageal reflux disease (GERD).

July 25, 2022

Nissen Fundoplication is a surgery in which a sphincter at the bottom of the esophagus is created by a surgeon to prevent acid reflux to treat gastroesophageal reflux disease (GERD).

Some facts about Nissen Fundoplication:

  • GERD or chronic acid reflux is a digestive system disorder in which your stomach acid and contents persistently flow back up through your esophagus.
  • A significant decrease in acid reflux symptoms can be noticed after the surgery.
  • Heartburn, regurgitation and dysphagia (difficulty swallowing) are common symptoms of gastroesophageal reflux disease.
  • Nissen fundoplication surgery is recommended for those people who does not get relief from acid reflux symptoms with medication or lifestyle changes.

Preparation for Nissen Fundoplication:

  • Your medical history and any prescription drugs or supplements you’re taking will be discussed by your healthcare provider.
  • Inform your healthcare provider if you have a history of bleeding disorders and let him know if you are taking any blood-thinning medicines, aspirin, ibuprofen, or other medicines that affect blood clotting as you may need to stop taking these medicines before the procedure.
  • If you are sensitive to or allergic to any medicines, latex, tape, contrast dyes, and anesthesia medicines (local and general), that should be informed.
  • All the medicines you take including both over-the-counter and prescription medicines and also any vitamins, herbs, and other supplements should be informed.
  • Do not eat or drink anything for up to 12 before the surgery.
  • You should stop smoking temporarily or permanently if you’re ready to quit as smoking can make it harder for your body to heal after surgery.
  • Any medications that is provided by your surgeon you should be taken right before surgery.
  • Your surgeon may order some test to examine your stomach and esophagus.
  • GI X-rays (barium swallow X-rays) can be done to take images of your esophagus, stomach and small intestine.
  • The pressure in your esophagus when you swallow can be measured by a Esophageal manometry.
  • The upper part of your stomach can be examined by Upper endoscopy.
  • A pH probe will be done to look for evidence of acid in the esophagus. 
  • Any narrowing in your esophagus can be accessed by using these test.
  • These test can also done to look for a hiatal hernia which can worsen GERD symptoms.

Procedure for Nissen Fundoplication:

  • An intravenous (IV) medication will be given so that you fall asleep
  • The junction between the esophagus and the stomach is tightened to prevent acid reflux in the procedure for Nissen Fundoplication.
  • Laparoscopic  and Open are two types of Nissen fundoplication surgery.
  • A tiny incisions (cuts) and cameras are used to view inside the body in laparoscopic procedures.
  • Laparoscopic Nissen fundoplication is a minimally invasive procedure in which the function of the lower esophageal sphincter can be restored by wrapping the stomach around the esophagus.
  • A new 'functional valve' will be created between the esophagus and the stomach that prevents reflux of the acid and bile (non-acidic fluid) from the stomach into the esophagus.
  • Larger incisions are used in open procedure so that the surgeon can access inside the body with larger instruments and more range of motion.
  • The upper part of the stomach (fundus) will be wrapped around the lower part of the esophagus and the incision will be closed with staples during open acid reflux surgery.