Fundoplication
(Anti Reflux Surgery)
A fundoplication is a surgical procedure performed for people with proven gastro-oesophageal reflux that cannot be managed with medication alone.
It is also performed as part of a hiatus hernia repair. It is usually performed laparoscopically.
The Procedure
The procedure is performed under a General Anaesthetic. Five ports are placed via small incisions. These are used to introduce instruments to retract the liver and to operate.
First, the hiatus (diaphragm opening for the oesophagus) is carefully inspected to see if there is a hernia present. Often there is some weakness to this area and it can be repaired at the same time. If it requires repair, stitches are used to tighten up the opening so it hugs the lower oesophagus.
To perform a fundoplication, the surgeon dissects the upper part of the stomach (the fundus) from the surrounding tissues to ensure that it is mobile enough to wrap around the abdominal portion of the oesophagus. Once the fundus is able to move freely, it is stitched in place there with surgical sutures. It can be wrapped around the front (anterior fundoplication) or back (posterior fundoplication); and it can be wrapped around partially or completely. Dr Gillespie can discuss these finer points with you. In essence, a greater degree of wrap will provide a tighter space for food to pass down and gastric acid to pass up and is therefore more effective, but at greater risk of causing swallowing difficulty.
Recovery
Post procedure most patients will stay for 1-2 nights. Mild chest and shoulder tip pain is common and pain relief is available for this. Most patients will only need simple analgesia by the time they are discharged.
Your diet will gradually increase- from fluids, to soft foods and eventually a full textured diet- over a period of a few weeks. After keyhole surgery your stitches are underneath the skin and dissolving. There are some small dressings that are removed within the first week.
Follow Up
Dr Gillespie will see you in the office 4-6 weeks after your surgery. At this time your diet will be progressed meaning you will be able to eat more normal food and we will discuss any persisting symptoms.
Usually by this time you can swallow as normal and your reflux has completely gone.
The Patient Journey
Book an appointment
Call or email Dr Gillespie’s rooms to book an appointment. You will need a referral from your GP or specialist if you would like a Medicare rebate.
First Consult
You'll meet with Dr Gillespie to discuss your history and what options might be right for you.
This consult is ideally in person but zoom calls are also available.
Preparation
If you would like to pursue surgery, a further workup may take place beforehand. This may include a gastroscopy, swallow study and/or a pH and manometry test.
Booking in for surgery
After you have been consented for surgery, Dr Gillespie’s secretaries can discuss being admitted as either a public or private patient, and the associated costs involved. A date for surgery can then be chosen.
Surgery
This will usually involve a one or two-night stay in hospital. You will be admitted on the day of surgery and the hospital will provide fasting instructions the day prior.
Follow up
You will have a follow up consult with Dr Gillespie in 4-6weeks post procedure.
If you have any questions or concerns beforehand, please contact the rooms via phone or email.