Fundoplication is a special operation on the esophagus and stomach. Most often it is performed as a therapeutic method for gastroesophageal reflux disease (GERD). GERD has a more familiar name for each person - heartburn. Heartburn occurs when gastric acid rises into the esophagus. During the procedure, a hernia of the food orifice of the diaphragm can be visualized by a doctor. This type of hernia occurs when part of the stomach enters the chest cavity. This type of hernia formation enhances the manifestation of GERD.
When recommended fundoplication
The operation is most often prescribed: to eliminate serious problems with the esophagus, which arose through prolonged exposure of gastric acid to the mucous membranes of the esophagus; for correction and elimination of the hernial formation of the food opening of the diaphragm; as a manipulation to suppress heartburn attacks, to reduce asthma attacks; as a method for the elimination of persistent and powerful signs of GERD, which are observed after medication.
Possible complications of fundoplication
If a procedure is planned, it is important to check with your doctor about possible complications. Among them may occur: an allergic reaction to anesthesia; damage to internal organs; limiting the ability of vomiting or belching; renewed reflux symptoms; difficulty swallowing; bleeding; infections.
Very rarely the procedure needs to be repeated. Repeat fundoplication is needed if there is a new hernia lesion. Among the factors that can provoke complications are: previous upper abdominal surgery; diabetes; smoking; large body mass; the presence of diseases of the lungs and heart.
Preparation for the procedure
Before conducting a fundoplication, the doctor must prescribe a number of laboratory and diagnostic procedures, as well as a special preparation of the patient.
As a survey is used:
- physical examination;
- manometry (a special test to measure muscle contractions inside the esophagus in response to swallowing);
- endoscopy (with the help of an endoscope, the state of the mucous membranes of both the esophagus and the stomach is examined, and tissue samples for histological examination are taken if necessary);
- X-ray (allows the doctor to examine the properties of the structure of organs, especially when using contrasting).
Before surgery, the patient should:
- Consult a doctor for advice on drug use. Approximately 7 days will need to abandon the following drugs: clopidogrel, warfarin (and other blood thinners), aspirin (anti-inflammatory drugs).
- For 12 hours to refuse to eat and water.
- Arrange all the conditions for staying home after surgery.
Description of the procedure
For the operation, general anesthesia is used, during which the patient is in a state of deep sleep and does not feel pain.
The doctor makes a small cut. With the help of a laparoscope (a small surgical instrument with a camera) all manipulations will be carried out. The camera displays an image on the monitor to the doctor, which helps to perform the operation qualitatively and not blindly. In order to improve conditions during the procedure, gas is pumped into the abdominal cavity. The doctor makes several more small incisions for inserting additional, auxiliary instruments into the abdominal cavity. Instruments capture the right edges of the stomach and wrap them around the esophagus. If necessary, the hernia closure is also manipulated.
Some doctors use abdominal technology, in other words, open surgery. In this case, the period of rehabilitation of the patient will be several times longer.
The whole procedure, depending on the complexity and complications, can last within 2-4 hours.
Restoration and care recommendations
The recovery period after surgery is accompanied by uncomfortable sensations. In order to improve the patient's well-being, doctors prescribe anesthetic therapy.
A patient after fundoplication needs special care:
- walking with outside support is possible only on the second day after the procedure;
- incisions should be regularly handled and covered with a dry and sterile dressing;
- during the bathing period, the incision site is covered with a special waterproof film (it will be possible to wet the incisions only in a week);
- food is mostly liquid (diet "table number 1");
- the doctor prescribes a course of anti-inflammatory and antibacterial drug treatment;
- It is important to follow all instructions and prescriptions of the doctor with maximum accuracy.
A full recovery period will take from six to eight weeks.
Complications after the procedure
A doctor should be contacted urgently if the following symptoms are noticed:
- severe chest pain, shortness of breath, cough;
- frequent urination with painful signs, with burning sensation and with blood in urine;
- pain in the abdomen, which do not respond to the use of painkillers;
- the presence of difficulty swallowing;
- the presence of edema in the abdomen;
- frequent bouts of nausea and vomiting that do not go away after taking the appropriate medication;
- bleeding, swelling, redness, severe pain, suppuration of the incision;
- various signs of infection, including chills and fever;
- other discomfort and pain symptoms.
Contraindications to the procedure
Categorically, fundoplication is contraindicated for persons with impaired motility, complete absence or limited functionality of peristalsis, and esophageal dyskinesia. It is also recommended to refuse the procedure if the patient has a shortened esophagus.
If you often suffer from bouts of heartburn, it is recommended to contact your gastroenterologist for diagnostic methods of examination and for the selection of treatment. Timely determination of pathology will avoid serious consequences.