The esophagus is a muscular passage which carries food from the mouth to the stomach. The lower esophageal sphincter (LES) is a circular band of muscles at the lower end of the esophagus that acts a barrier between esophagus and the stomach.
Gastro-esophageal reflux disease (GERD) is a chronic disease that occurs when the lower esophageal sphincter closes incompletely allowing the stomach contents to leak back or reflux into the esophagus. In certain individuals, a hiatal hernia may be present which can also be a cause of reflux or heartburn. In some individuals, this causes heartburn, a burning sensation felt in the chest or throat when the refluxed stomach acid touches the lining of the esophagus. Additionally, some have significant regurgitation of acid, bile, or food contents which can be debilitating.
We are proud to offer the full range of interventions for reflux. Interventions include, LINX, Laparoscopic or Robotic Nissen Fundoplication, and in individuals with a BMI above 35kg/m2, Laparoscopic or Robotic Gastric Bypass.
Nissen fundoplication and LINX are both minimally invasive procedures performed to restore the function of lower esophageal sphincter. Gastric bypass helps to isolate the acid producing portion of the stomach from the esophagus, thereby eliminating reflux.
- Hiatal hernia is a condition in which the stomach bulges up into the chest through an opening in the diaphragm.
- Chronic esophagitis (inflammation of esophagus)
- Barrett’s Esophagus
- Failed conservative treatment measures such as medications and lifestyle modification.
- Lack of desire to stay on acid reducing medications indefinitely
LINX, is a new and innovative magnetic bracelet-like device that wraps around the bottom portion of the esophagus. This is placed through laparoscopic or robotic techniques. When you swallow, the magnets relax allowing for passage of food. However, these magnets are increasing the effectiveness of the lower esophageal sphincter to help prevent reflux or heartburn. This functions as a two-way valve allowing for reliable passage of food but limiting problematic reflux symptoms.
Nissen Fundoplication long-held as the gold standard in surgical treatment of reflux, the surgeon wraps the top most portion of stomach around the esophagus to prevent the back up of acid from the stomach into the esophagus. This functions as a one-way valve limiting reflux symptoms. The procedure is typically performed laparoscopically or robotically.
For Gastric bypass please see “Weight Loss Surgery”
The acid producing portion of the stomach is isolated from the esophagus, thereby limiting the possibility of acid and/or bile from traveling from the stomach into the esophagus to cause reflux or heartburn symptoms. In patients with a BMI > 35kg/m2, this is usually the most favorable option as it addresses multiple contributors to reflux disease. This is also performed through minimally invasive techniques.
After the surgery
Following the surgery, your surgeon may recommend you follow certain measures for a successful outcome:
- Avoid heavy lifting and activities that put excessive pressure on the abdomen.
- Your doctor will prescribe medications to relieve pain.
- Keep the incision area clean and dry.
- Your post-operative diet will be dictated by the type of procedure performed.