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ANTI REFLUX SURGERY (FUNDOPLICATION) IN INDIA

What Is Laparoscopic Anti-Reflux Surgery?

Antireflux surgery is performed to correct the reflux of acid up into the gullet from the stomach. The main symptom of reflux is heartburn (a burning pain felt under the breast bone). In the past the only surgical option was the open method, which involved a large cut in either the upper part of the abdomen or the chest. This was a very painful procedure and involved at least 5-7 days in hospital, plus a long recovery period. The same procedure is now performed laparoscopicaly, using what is popularly known as the keyhole approach. The operation is performed through 5 small puncture holes instead of through a large incision, and involves usually only an overnight stay in hospital though some patients may be discharged home on the same day.

When Is Surgery Necessary?

People with severe, chronic esophageal reflux might need surgery to correct the problem if their symptoms are not relieved through other medical treatments. If left untreated, chronic gastroesophageal reflux can cause complications such as esophagitis, esophageal ulcers, bleeding, or scarring of the esophagus.

Laparoscopic antireflux surgery (also called Nissen fundoplication) is used in the treatment of GERD when medicines are not successful. Laparoscopic antireflux surgery is a minimally-invasive procedure that corrects gastroesophageal reflux by creating an effective valve mechanism at the bottom of the esophagus.

What Are the Advantages Of Laparoscopic Anti-Reflux Surgery?

Reduced post operative pain. Following laparoscopic anti-reflux surgery you should feel abdominal discomfort for 1-2 days and minimal pain thereafter.

Shorter hospital stay. Your hospital stay should only involve 1-2 nights.

A faster return to work. Those with sedentary jobs should be able to resume work within 1-2 weeks and for heavy manual work, within 3-4 weeks.

Improved cosmetic result. Minimal scarring is present.

Medical Treatment of Reflux Surgery in India

Lifestyle changes : – The most important lifestyle change to improve the symptoms of reflux is losing weight. If you are overweight, there is often a critical weight. Below this the symptoms of reflux will improve dramatically, above it, reflux will be prominent. Reducing smoking and alcohol consumption will also be helpful. Changing eating habits will also improve symptoms. It is important to have regular meals and to have the last meal several hours before going to bed.

Drug therapy : – Drug therapy is usually very successful at improving the symptom of heartburn. Antacids neutralise the stomach acidity and will relieve relatively mild symptoms. If these fail then stronger prescription drugs may be necessary. These are known as proton pump inhibitors. There are several different types of proton pump inhibitors. These drugs dramatically reduce the gastric acid shutting it down to minimal levels. These drugs are usually very effective at relieving heartburn.

Surgery in India

Surgery is required if medical treatment fails to relieve the symptoms, or, if the medication satisfactorily relieves the symptoms but as soon as the medication is stopped, the symptoms recur. Under these circumstances a large number of patients prefer to go to surgery rather than take medication for the rest of their lives. This particularly applies to the younger aged patients. Surgery now is performed using laparoscopic (key hole) techniques.

Risks For This Surgery Are : –

• Gas bloat, which makes it hard to burp or throw up. It also causes bloating after meals. These symptoms slowly get better for most people.
• Pain and difficulty when you swallow, for some people. This is called dysphagia. For most people, this goes away in the first 3 months after surgery.
• Damage to the stomach, esophagus, liver, or small intestine. This is very rare.
• Respiratory complications, such as a collapsed lung. This is also rare.
• Recurrence of the hiatal hernia

Recovering From Surgery in India

Once you have recovered from anesthesia, you will be transferred to your hospital room. After your surgery, the nurses will measure your “intake and output.” They will document all the fluids that enter your body, and measure and collect any urine or fluids you produce, including those from tubes or drains placed during surgery.

• Diet – Your diet guidelines will be directed by your surgeon. You may begin to drink water the night of surgery. You may progress to other clear liquids the day after surgery. You will gradually be able to drink other liquids and eat soft foods. You will gradually be able to eat solid foods (within three to four days after surgery).

• Activity – You will be encouraged to get out of bed, starting the night of surgery. The more you move, the less chance for complications such as pneumonia or blood clots in the veins in your legs. Activity will also help remove the carbon dioxide in your abdomen.

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