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    All Posts Tagged: Fundoplication Surgery

    Comments Off on Precautions after a Nissen (laparoscopic) Fundoplication Surgery for GERD
    Nissen Fundoplication Surgery

    Precautions after a Nissen (laparoscopic) Fundoplication Surgery for GERD

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    Laparoscopic Nissen fundoplication is a surgical approach to treating gastroesophageal reflux disease (GERD). This surgery aims to strengthen the weakened area of the esophagus that causes stomach acid to flow up instead of down. Nissen fundoplication surgery is designed to fix the weak area of the esophagus. The surgery is performed laparoscopically.

    Few complications after a fundoplication surgery are difficulty in swallowing, esophagus sliding out of the wrapped portion of the stomach, Bloating and discomfort from gas buildup, excess gas, risks of anesthesia, risks of major surgery (infection or bleeding).

    If an open surgery is done, you have to spend several days in the hospital and you may need 4 to 6 weeks to get back to your normal routine. If the laparoscopic surgery method is used, you have to stay in the hospital for only 2 to 3 days and most people can go back to their normal routine in about 2 to 3 weeks.

    After your surgery, you have to follow a special diet to help prevent diarrhea, gas, and problems swallowing. You can drink clear liquids for your first few meals. Then follow a full liquid diet and then a Nissen soft diet. Eat small, frequent meals (six to eight per day). This will help you consume the majority of the nutrients you need without causing your stomach to feel full or distended. Drinking large amounts of fluids with meals can stretch your stomach.

    Eat very slowly. Take small bites and chew your food well which will help in swallowing and digestion. Avoid crusty breads and sticky, gummy foods, such as bananas, fresh doughy breads, rolls and doughnuts. Sit upright while eating and stay upright for 30 minutes after each meal. Do not lie down after eating. Sit upright for 2 hours after your last meal or snack of the day.

    The first bowel movement may occur anywhere from one to five days after surgery. As long as you are not nauseated or having abdominal pain, this variation is acceptable. Remember that it is very common to pass a lot more gas from your rectum; this is because you will not be able to really belch.

    There are no significant restrictions on activity after surgery. You can walk, climb stairs, mow the lawn or exercise, as long as it does not put a strain on you. Returning to normal activity as soon as possible will most likely enhance your recovery. Try to avoid heavy lifting for several weeks.

    Important –

    Contact your surgeon immediately, if a fever arises up to 100.4 or greater, shaking chills, pain that increases over time, redness, warmth, or pus draining from incision sites, persistent nausea or inability to take in liquids.

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    Comments Off on Laparoscopic Fundoplication or Anti Reflux Surgery is the Best Surgical Option for Failed Treatment of GERD
    Laparoscopic Fundoplication or Anti Reflux Surgery is the Best Surgical Option for Failed Treatment of GERD

    Laparoscopic Fundoplication or Anti Reflux Surgery is the Best Surgical Option for Failed Treatment of GERD

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    GERD patients who are not getting benefitted by life style modifications and medications will require reference to surgical gastroenterologist to assess for anti reflux surgery (Nissen fundoplication).

    Gastro esophageal reflux disease (GERD) is a condition which occurs due to the reflux of acids from the stomach back into the esophagus (food pipe) due to improper functioning of lower esophageal sphincter (LES) located between stomach and esophagus. This resultant, harsh acid causes a burning sensation (Heart Burn) in the area between the ribs or just below the neck which may sometimes radiate along the chest into the jaws and throat.

    Commonly experienced complaints may include nausea, vomiting, regurgitation, difficulty in swallowing, chronic cough with or without wheezing.

    Patients with mild GERD could be treated with lifestyle modifications such as avoiding alcohol, avoiding spicy & salty food, losing weight, quit smoking, using 2-3 pillows while sleeping and practicing proper sleeping patterns whereas some may require medications like antacids, H2 blockers or proton pump inhibitors (PPIs).

    However, patients who are not responding to both these ways of treatment will require surgical interventions. The latest and the most preferred surgical therapy for GERD includes Fundoplication Surgery, which can be done either as an open procedure or laparoscopically. The primary objective of fundoplication is to reinforce the LES to redevelop the barrier which will prevent the occurrence of reflux back from the stomach.

    The procedure is carried out by wrapping a portion of the stomach around the bottom part of the esophagus in order to strengthen the affected LES valve. Being the commonest and most preferred type of surgery, Nissen fundoplication uses a method where the stomach itself is wrapped 360 degrees around the lower esophagus so that acid reflux will completely get halted. Also, there are other types of surgeries which do not involve a complete wrap up around the stomach. However, Nissen fundoplication is known to be the treatment of choice for GERD.

    Similar to most surgeries done these days, fundoplication can also be performed using a minimally invasive method of laparoscopy in which a narrow tube-like camera is inserted into the abdomen through small incisions on the abdominal wall.

    The major benefits of this minimally invasive technique involves,

    • Minimal pain
    • Short duration of hospital stay
    • Quick recovery
    • Tiny scars which are rarely visible
    • A very low risk of wound infections and hernias

    According to research studies, following the laparoscopic anti-reflux surgery, both short-term (1–5 years) and long-term follow-ups (5–10 years) have proved that majority of patients have shown an effective improvement, a high satisfaction with an enhanced quality of life. More importantly, all most all the patients have taken off the anta-acid drugs, they have been using for a long period of time, after the surgery. Interestingly, most patients have consistently answered that they would not think twice to go through the anti-reflux surgery if necessary due to its extremely comfortable nature.

    However, even if complications like adverse effects of general anesthesia, bleeding, infection or injury to nearby organs are possible, the surgery when performed by an experienced Laparoscopic GI surgeon is exceptionally safe where life threatening outcomes are highly unusual.

    Laparoscopic fundoplication or anti reflux surgery is known to be the best surgical option available for failed treatment of GERD and large hiatal hernias due to its comparatively effective consequences.

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    Comments Off on Laparoscopic Fundoplication is Reliable Surgical Procedure for GERD
    Life style modifications for GERD

    Laparoscopic Fundoplication is Reliable Surgical Procedure for GERD

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    Are you also suffering from mild or severe heartburn and regurgitation which interferes with your day to day activities?

    Then, you may be a victim of the commonly prevailing condition known as Gastro-esophageal reflux disease, or GERD. This occurs due to reflux of stomach acids from the stomach back into the esophagus due to lax lower esophageal sphincter (LES) located between stomach and esophagus.

    Commonly experienced presenting complaints may include burning sensation in throat /Chest (Heart burn), nausea, vomiting, regurgitation, difficulty in swallowing, chronic cough with or without wheezing.

    Some patients with mild GERD could be treated with life style modifications such as change of dietary pattern, usage of over the counter anta-acids when necessary, losing weight, quit smoking and alcohol, and practicing proper sleeping patterns whereas some may require medications like anta-acids which will neutralize acids, flowing back to the esophagus.

    However, patients who are not responding to both these ways of treatment will require surgical interventions. The latest and the most preferred surgical therapy for GERD includes Fundoplication Surgery, which can be done either as an open procedure or laparoscopically.

    As far as the technique of fundoplication is concerned, the patient will be made unconscious and pain free by administering general anesthesia. The upper curvature of the stomach also known as fundus is sutured as a wrapping around the esophagus, allowing the lower portion of the esophagus exit through a tiny canal formed by the stomach muscle.

    This method will help to tighten the lower esophageal sphincter, and there by stop the back flow of stomach acids. The already damaged, or inflamed esophageal lining will heal eventually and the symptoms will improve over time.

    If the patient undergoes an open surgery which generally needs a larger incision, he will be advised to stay in the hospital for a few days and can return back to routine work within 4-6 weeks whereas in the case of laparoscopic fundoplication surgery, he will be discharged within 2-3 days and can get back to day to day work within 2-3 weeks.

    Most of the patients who undergo fundoplication surgery will recover completely over time while some may rarely develop a recurrence with new symptoms like bloated feeling in the stomach, flatulence and renewed heart burn which may require further medication or even another surgery. Other possible complications are a difficulty in swallowing if the stomach is wrapped too high or too tightly on the esophagus during the procedure or develop general complications of anesthesia.

    However, GERD is a condition which can reduce the quality of one’s life in a long term basis due to its irritating and painful nature and therefore it is worth trying to undergo a fundoplication surgery, in case where life style modifications and medical interventions fail.

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      I was diagnosed with gall stones a year ago in Delhi, I showed it to a doctor at Max hospital, he just asked me to get a surgery done and get my gall removed on any date of my choice, I was sacred and too young to get it done I got a vibe from doctor that for him it’s just a small things, however according to for a patient it’s important first be convinced on the urgency to get it done and feel safe . A year later I shifted to Mumbai and started having a frequent pain in shoulder blades and gall area. It went sharp this time. We went to Dr Nitish , as oppose to Delhi doc, Dr Nitish was very polite, first asked us to get the scan done and understand the current scenario, the scan showed one big 17 mm stone which was earlier also there but this time also there were multiple various sized stones as well along with the big one. Dr Nitish examined the scan, explained me and my husband about the condition and need of surgery or else the stone Would have slipped in the panacea or bile calling for a bigger operation. He explained diagramatically . He was patient in explaining, gave us time to think and be convinced. We were ready and then he performed it . It was flawless, quick and went well. He is a very experienced and fine surgeon , he is caring and doesn’t create panic at all rather he takes it slowly and makes patient comfortable. It was lapro, it’s been 2 months I m writing this . I faced no issues till now. Apollo staff was also very caring and good. I would mention Apollo Hospital, Navi Mumbai in specific. Good follow up diet makes it normal. I would strongly recommend Dr Nitish. He knows his job perfectly. He is not money minded at all. He would recommend surgery only if it’s required.

      Aneesha

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      I was diagnosed with gall stones a year ago in Delhi, I showed it to a doctor at M.... hospital, he .... asked me to get a surgery done and get my gall removed on any date of my choice, I was sacred and too young to get it done I got a vibe from doctor that for him it’s just a small things, however according to for a patient it’s important first be convinced on the urgency to get it done and feel safe . A year later I shifted to Mumbai and started having a frequent pain in shoulder blades and gall area. It went sharp this time. We went to Dr Nitish , as oppose to Delhi doc, Dr Nitish was very polite, first asked us to get the scan done and understand the current scenario, the scan showed one big 17 mm stone which was earlier also there but this time also there were multiple various sized stones as well along with the big one. Dr Nitish examined the scan, explained me and my husband about the condition and need of surgery or else the stone Would have slipped in the panacea or bile calling for a bigger operation. He explained diagramatically . He was patient in explaining, gave us time to think and be convinced. We were ready and then he performed it . It was flawless, quick and went well. He is a very experienced and fine surgeon , he is caring and doesn’t create panic at all rather he takes it slowly and makes patient comfortable. It was lapro, it’s been 2 months I m writing this . I faced no issues till now. Fortis staff was also very caring and good. I would mention fortis Vashi in specific. Good follow up diet makes it normal. I would strongly recommend Dr Nitish. He knows his job perfectly. He is not money minded at all. He would recommend surgery only if it’s required.

      Aneesha

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      I had surgery of my left hydrocele on 27th May 2017 by Dr Nitish Jhawar. An excellent experience of service I got particularly from Dr Jhawar. He is not only a qualified experienced doctor but also a splendid human being. Thanks a lot.

      Kishor Kumar Das

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      It was a Laparoscopic operation for the removal of Gall Bladder (stones). I had developed on and off pain in abdomen before the operation, after the operation feeling good, totally pain free. Thanks and respect for handling my case very well.

      Siddappa A. Hasbi

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      I met doctor Nitish for piles problem and wanted to undergo LASER procedure only, my operation is successful and I thank doctor for being a good human being and great surgeon.

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      I was suffering from piles since long time. For bleeding heavily I met Dr Nitish Jhawar and after meeting him decided to go for Stapler surgery for piles. I found him a doctor who listens to our problem and explains properly.

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      I got diagnosed about a year back but was avoiding operation for Hernia repair, Dr Nitish Jhawar explained me why surgery should be done and I chose surgery by laparoscopy method. I am happy with the doctor and the hospital.

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      I visited for Gall Bladder removal by Laparoscopy after searching for best laparoscopic surgeon. After meeting dr my fear for surgery was vanished and my surgery went well and recovery was smooth.

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      Very good he describe everything in very pleasant manner about the problem which was very helpful to me to understand my disease.

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