What is laparoscopic Nissen fundoplication?

Laparoscopic Nissen fundoplication is a procedure which is performed for the treatment of severe gastroesophageal reflux disease (GERD). GERD is a fairly common digestive condition that occurs when the contents of the stomach moves backwards into the oesophagus, leading to heart burn, and in some cases, difficulty swallowing. The condition can also cause breathing problems, such as asthma and laryngitis. Laparoscopic Nissen fundoplication is generally only recommended in cases where chronic GERD cannot be treated or properly managed with the use of medications and lifestyle changes or when there are some other complications related to the hernia.

What does the procedure involve?

The procedure is performed under general anaesthetic. During the procedure, Dr Govender will make some very small incisions in your abdomen, through which tiny surgical instruments will be inserted. Carbon dioxide will be used to inflate your abdomen, which creates adequate space for the surgery to be performed. Dr Govender will dissect the stomach out of the chest, suture the hiatus back to normal size (occasionally with the use of a mesh) and then carefully wrap the upper part of your stomach around the lower part of your oesophagus. This tightens the closing mechanism of the lower part of the oesophagus, and works to create a one-way valve. This helps to prevent stomach acid from moving backwards into the oesophagus.

In most cases, the laparoscopic Nissen fundoplication procedure takes between 60 and 90 minutes to complete. You may need to stay in hospital for two or three days following surgery, during which time you will monitored and encouraged to eat soft foods while you recover. You will get help from a dietitian.

What can I expect after the procedure?

You will need to stick to a soft diet for around six to eight weeks following the procedure. You will also need to avoid strenuous exercise and heavy lifting for six weeks while you recover from surgery. Dr Govender will request a follow-up consultation within two to six weeks to ensure that you have healed adequately.