Skip navigation | ||
|
||
Medical Encyclopedia |
|
Other encyclopedia topics: | A-Ag Ah-Ap Aq-Az B-Bk Bl-Bz C-Cg Ch-Co Cp-Cz D-Di Dj-Dz E-Ep Eq-Ez F G H-Hf Hg-Hz I-In Io-Iz J K L-Ln Lo-Lz M-Mf Mg-Mz N O P-Pl Pm-Pz Q R S-Sh Si-Sp Sq-Sz T-Tn To-Tz U V W X Y Z 0-9 |
Contents of this page: | |
|
|
Alternative names Return to top
Fundoplication, Anti-reflux surgeryDefinition Return to top
This procedure corrects a defect in the diaphragm (breathing muscle), which separates the chest cavity from the abdominal cavity. A hiatal hernia occurs when the normal opening in the diphragm is too large. If the defect is not repaired, the stomach or other abdominal contents may bulge (herniate) into the chest, causing heartburn (gastroesophageal reflux) and serious damage to the esophagus.Description Return to top
When the opening (hiatus) in the diaphragm is too large, part of the stomach can slip up into the chest cavity. Gastric acid backflows from the stomach into the esophagus, which can cause gastroesophageal reflux (GER). Over many years GER can damage the lining of the esophagus and in some cases may lead to cancer of the esophagus.
For an open hiatal hernia repair, an incision is made in the abdomen while the patient is under general anesthesia. The stomach and lower esophagus are placed back into the abdominal cavity. The hiatus is tightened and the stomach is stitched in position within the abdominal cavity. The upper part of the stomach (fundus) may be wrapped around the esophagus (fundoplication) to reduce reflux. Sometimes the surgeon will place a temporary tube from the stomach through the abdominal wall to keep the stomach in place.
In some patients, this operation can also be performed laparoscopically (also known as "keyhole" or "telescopic" surgery). In a laparoscopic fundoplication, small (1 cm) incisions are made in the abdomen, through which instruments and a fiberoptic camera are passed .
The laparoscopic procedure is performed using these small instruments while the surgeon watches the image on a video monitor. Laparoscopic fundoplication results in less pain and scarring and shorter hospitalization times than the open procedure but is not suitable for all patients.
Indications Return to top
Hiatal hernia repair may be recommended when the patient has some of these symptoms:Risks Return to top
Risks for any anesthesia include the following:Risks specific to this surgery include the following:
Expectations after surgery Return to top
Fundoplication is a safe, effective operation. Reflux is greatly reduced or eliminated in 95% of patients.Convalescence Return to top
Patients typically spend 1 to 3 days in hospital after laparoscopic surgery, or 2 to 6 days after open surgery. A tube will be placed into the stomach through the nose and throat (nasogastric tube) during surgery. Some surgeons like to leave the tube in for a few days, while others do not. Small, frequent feedings and avoidance of gas-producing foods are recommended. Most patients go back to work in 2-3 weeks for laparoscopic surgery, or 4-6 weeks after open surgery. Update Date: 4/13/2004 Updated by: John A. Daller, M.D., Ph.D., Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas. Review provided by VeriMed Healthcare Network.
Home | Health Topics | Drug Information | Encyclopedia | Dictionary | News | Directories | Other Resources | |
Copyright | Privacy | Accessibility | Selection Guidelines U.S. National Library of Medicine, 8600 Rockville Pike, Bethesda, MD 20894 National Institutes of Health | Department of Health & Human Services |
Page last updated: 28 October 2004 |