Laparoscopic fundoplication for reflux and GORD in Otago and Southland
Fundoplication surgery is a commonly performed procedure used to treat severe acid reflux and gastro-oesophageal reflux disease (GORD).
For patients whose symptoms continue despite medication, surgery can provide long-term control of reflux and significantly improve quality of life.
Mark Grant is an Upper Gastrointestinal and Bariatric Surgeon based in Dunedin, providing laparoscopic fundoplication surgery for patients throughout Otago, Southland, Queenstown, Wanaka and Invercargill.
What is fundoplication surgery?
Fundoplication is a surgical procedure designed to strengthen the valve between the oesophagus and the stomach.
In reflux disease, this valve, called the lower oesophageal sphincter, becomes weak and allows stomach acid to flow backwards into the oesophagus.
During fundoplication surgery, the upper part of the stomach is wrapped around the lower oesophagus to reinforce this valve and prevent reflux.
The procedure is usually performed using laparoscopic (keyhole) surgery.
What conditions does fundoplication treat?
Fundoplication surgery is commonly used to treat:
- gastro-oesophageal reflux disease (GORD)
- chronic acid reflux
- reflux not controlled by medication
- reflux associated with a hiatus hernia
- regurgitation of stomach contents
In many patients, the procedure is performed at the same time as hiatus hernia repair.
Symptoms of reflux that may lead to surgery
Patients considered for fundoplication surgery often experience persistent symptoms such as:
- heartburn after eating
- acid regurgitation
- waking at night with reflux
- chronic cough or throat irritation
- hoarse voice or throat discomfort
- difficulty swallowing
When symptoms persist despite medication, surgery may provide a more durable solution.
Types of fundoplication
Several types of fundoplication procedures may be performed depending on individual anatomy and oesophageal function.
Nissen fundoplication
The most common operation is a 360-degree wrap, known as a Nissen fundoplication.
This creates a strong anti-reflux valve.
Partial fundoplication
In some patients, a partial wrap may be recommended.
Examples include:
- Toupet fundoplication (270° wrap)
- Dor fundoplication (anterior wrap)
These options may reduce the risk of swallowing difficulty in selected patients.
Your surgeon will recommend the most appropriate procedure based on pre-operative testing.
Investigations before fundoplication surgery
Before surgery, several investigations may be required to confirm the diagnosis and assess oesophageal function.
These may include:
- gastroscopy
- oesophageal manometry
- 24-hour pH monitoring
- imaging for hiatus hernia
These tests help ensure that surgery is likely to improve symptoms.
How laparoscopic fundoplication is performed
Fundoplication surgery is performed using minimally invasive techniques.
During the procedure:
- Small incisions are made in the abdomen
- The stomach is returned to its normal position if a hiatus hernia is present
- The hiatus in the diaphragm is repaired
- The upper stomach is wrapped around the lower oesophagus to reinforce the valve
The procedure typically takes one to two hours.
Because it is laparoscopic surgery, recovery is generally faster than with traditional open surgery.
Recovery after fundoplication surgery
Most patients stay in hospital one night after surgery.
During recovery patients can expect:
- gradual progression from soft foods to normal diet
- mild swallowing difficulty during early healing
- return to normal activities within two to three weeks
Patients are usually advised to avoid heavy lifting for several weeks.
Expected results
Fundoplication surgery has been performed for many decades and has well-established long-term results.
Studies show that:
- most patients experience significant improvement in reflux symptoms
- many patients can stop reflux medication
- approximately 80% of patients remain symptom free 10 years after surgery
Individual results vary depending on anatomy and underlying oesophageal function.
Possible side effects
Side effects after fundoplication surgery are generally uncommon.
Potential side effects may include:
- temporary difficulty swallowing
- gas bloating
- reduced ability to belch
These symptoms usually improve as healing occurs.
Fundoplication surgery for patients across Otago and Southland
Patients often travel to Dunedin for specialist Upper GI surgery.
Mark Grant provides reflux and fundoplication surgery for patients from:
- Dunedin
- Queenstown
- Wanaka
- Invercargill
- Oamaru
- Central Otago
Consultations are usually arranged following referral from a GP or specialist.
Consultation for reflux surgery
If reflux symptoms are affecting your quality of life, specialist assessment can help determine whether fundoplication surgery is appropriate.
Your consultation may include discussion of symptoms, investigations and treatment options.
FAQs
How successful is fundoplication surgery?
Most patients experience significant improvement in reflux symptoms and reduced need for medication.
How long does recovery take?
Most patients return to normal activities within two to three weeks after surgery.
Will I still need reflux medication?
Many patients no longer require reflux medication after surgery, although some may occasionally use medication.
Can reflux return after surgery?
A small number of patients may experience recurrence of symptoms over time.