GERD or gastro-esophageal reflux disease is a complex disease. A variety of malfunctioning systems contribute to GERD. Esophageal motility, lower esophageal sphincter tone, hiatal hernia, gastric fundus relaxation as well as gastric emptying are some of these systems that contribute to reflux.
The Nissen Fundoplication surgery is the gold standard surgery for treatment of acid reflux. The Nissen surgery is associated with more than 85% success rate in stopping acid reflux.
It is believed that a Nissen Fundoplication stops acid reflux by strengthening the weakened lower esophageal sphincter. In fact, the upper part of the stomach called gastric fundus is mobilized during a Nissen Fundoplication surgery and wrapped around the lower esophageal sphincter. In this fashion, the gastric fundus creates pressure around the lower esophagus. This high-pressure area prevents acid from backing up into the esophagus.
Another mechanism by which a Nissen Fundoplication works is believed to involve moving the acid bubble away from the gastro-esophageal area. According to this theory, by wrapping the gastric fundus around the esophagus, gastric motility is changed in such a way that acid no longer lingers at the junction between the esophagus and stomach. Thus, acid reflux is less likely to occur.
Irrespective of the mechanism of action, a Nissen fundoplication must be properly and meticulously performed to be effective. Attention to detail during Nissen surgery cannot be over-emphasized. The esophagus must be adequately mobilized to gain at least 3 cm of esophagus inside the abdomen. The left and right diaphragmatic pillars (hiatal hernia edges) are then approximated using sutures reinforced with pledgets to add strength and durability to the repair. The gastric fundus must be completely mobilized especially posteriorly and wrapped under no tension around the esophagus. Every single step in a Nissen Fundoplication surgery is crucial to its overall success.
At Houston Heartburn and Acid Reflux center, it is our privilege to take care of you. We are eager to share with you the latest treatment options for acid reflux disease. We are conveniently located at 5 acid reflux clinics across the Houston metro area. Please visit our website at houstonheartburn.com for more information.