Treatment For Reflux Disease (GERD/GORD)
- Antacids: over-the-counter medicines that provide temporary relief to heartburn and indigestion by neutralising acid in the stomach
- Other medications: reduce the production of acid in the stomach
- Endoluminal gastroplication or endoscopic fundoplication technique: minimally-invasive method that requires the use of an endoscope with a sewing device attached to the end, known as an EndoCinch device. This instrument places stitches in the stomach below the LES to create a plate which helps reduce the pressure against the LES and strengthen the muscle.
- Laparoscopic fundoplication: is a surgical procedure in which the upper part of the stomach is wrapped around the end of your oesophagus and oesophageal sphincter, where it is sutured into place. This surgery strengthens the sphincter and helps prevent stomach acid and food from flowing back into the oesophagus.
If conservative treatment options fail to resolve your GORD, your doctor may recommend a surgical procedure called laparoscopic Fundoplication. Nissen or Toupet Fundoplication surgery reinforces the lower oesophageal sphincter's ability to close and helps to prevent gastro-oesophageal reflux from occurring. This surgery can be performed laparoscopically through tiny incisions in the abdomen or through an open approach, which requires a large abdominal incision.
Anti-Reflux Surgery (Nissen or Toupet Fundoplication)
It is performed under general anaesthesia. Steps involved in laparoscopic Nissen or ToupetFundoplication procedure include:
- Your surgeon makes a small incision in the upper abdomen and inserts a tube called a trocar through which the laparoscope is introduced into the abdomen. A laparoscope is a long, narrow telescope with a light source and video camera at the end. The scope is passed through a tiny incision into the abdomen where images from the camera are projected onto a large monitor for the surgeon to view. Laparoscopes have channels inside the scope enabling your surgeon to pass gas in and out to expand the viewing area or to insert tiny surgical instruments for treatment purposes.
- Additional small incisions may be made for other surgical instruments.
- With the images from the laparoscope as a guide, your surgeon wraps the upper part of the stomach, the fundus, around the lower oesophagus to create a valve, suturing it in place.
- The hole in the diaphragm through which the oesophagus passes is then tightened with sutures.
- The laparoscope and other instruments are removed and the gas released.
- The tiny incisions are closed and covered with small bandages.
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