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Laparoscopic Anti-Reflux Surgery In A Nutshell
Nissen Fundoplication is a procedure targeted at treating heartburn due to Gastroesophageal Reflux Disorder, more commonly referred to as GERD. Gastroesophageal Reflux Disease (GERD) is a digestive disorder that occurs when stomach juices or food and fluids frequently flow back up from the stomach into the oesophagus. This phenomenon is also known as acid regurgitation, acid reflux, or gastroesophageal reflux. The frequent occurrence of gastroesophageal reflux can also cause the weakening of the muscles along the lower oesophageal sphincter (LES), which controls the opening between the oesophagus and the stomach. Nissen Fundoplication helps strengthen this opening to prevent food and acid from going back up. 
This procedure is also one of the most common surgeries used to treat GERD and has a high success rate in helping patients recover and prevent recurrence in the long run. This procedure can be done with keyhole or laparoscopic surgery. The surgeon takes the top part of the stomach and wraps it around your lower oesophagus. It allows the repair of the muscle around the lower oesophagus. This makes it less likely that acid will flow back up the oesophagus. This procedure is called laparoscopic fundoplication. Laparoscopy means that the surgery is done as the surgeon operates through several small keyhole incisions instead of a single large incision. This procedure is minimally invasive and offers better visualisation than open surgery. As compared with traditional fundoplication, laparoscopic fundoplication has a faster recovery time, significantly less pain and minimal scarring. _______
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Nissen Fundoplication is primarily used to treat patients with GERD, or in other cases, patients diagnosed with a hiatal hernia, where the stomach pushes against the diaphragm. This procedure is usually recommended for patients who experience prolonged periods of severe heartburn. This means that there is daily burning pain behind the chest bone for a few months. Surgery is especially indicated if the pain persists despite medication and lifestyle changes.
A patient will usually be advised to start with mild treatment or lifestyle changes before being recommended for surgery. These recommendations can include:
Nissen Fundoplication serves to tighten and reinforce the lower oesophageal sphincter (LES). In the procedure, the upper part of the stomach is wrapped around the lower oesophagus’s exterior to strengthen the sphincter. This procedure is also observed to be highly successful and help improve the patient’s lifestyle in the long run.
Nissen Fundoplication can be performed as an open surgery or laparoscopically. In open surgery, the surgeon makes a long incision in your stomach to access the oesophagus. On the other hand, most Nissen Fundoplication procedures are performed laparoscopically (also known as keyhole surgery.) “Laparoscopic” means that the surgeon operates through several small keyhole incisions instead of a single large incision. This procedure is minimally invasive and offers better visualisation than open surgery. As compared with traditional fundoplication, laparoscopic fundoplication has a faster recovery time, significantly less pain, and minimal scarring. In both procedures, a Nissen Fundoplication involves wrapping the entire upper part of the stomach around the oesophagus. The surgeon takes the top part of the stomach and wraps it around the lower oesophagus. It allows the repair of the muscle around the lower oesophagus. This makes it less likely that acid will flow back up the oesophagus.
Anti-reflux surgery is typically done to treat severe heartburn. This means that there is daily burning pain behind the chest bone for a few months. Surgery is recommended especially if the pain persists despite medication and lifestyle changes. These symptoms occur if the muscles between your oesophagus and stomach are not tight enough. This allows acid to flow back up to the oesophagus, causing discomfort.
A Nissen Fundoplication is a relatively safe procedure when performed laparoscopically. This allows smaller incisions to be made and aids in faster recovery. However, as with most surgeries, some patients may experience rare cases of complications. The complications may include:
In extremely rare cases, a Nissen Fundoplication may fail and result in the recurrence of the reflux symptoms. In such cases, the wrap around the oesophagus could have been too tight or incorrectly placed, resulting in the need to repeat the surgery to fix the failure.
A patient who has undergone a fundoplication would be advised to make dietary changes to avoid complications after the procedure. A dietary change can also aid in preventing any long term effects of discomfort following the surgery. Following the surgery, you will be expected to make the changes to your diet according to the different phases. This is what may be recommended:
A patient who undergoes a fundoplication procedure can be discharged within two days after the surgery. Patients who opt for open surgery may be required to stay longer as the operation involves a bigger incision, requiring more extended periods to recover. Following the surgery, you will likely require tube feeding in the initial two weeks.
After that, patients will resume consumption of a liquid diet for another two weeks before progressing to soft foods and finally returning to eating normally after 1 to 3 months. Depending on whether you opt for open surgery or laparoscopic surgery for your fundoplication, the recovery of your wound would also differ.
Similarly, the recovery of the wound will differ between individuals. Most patients should recover within two weeks from the surgery if there are no serious complications or infections observed. For a more accurate assessment of your recovery period, you may seek advice from our doctor to get a clearer picture.
At G&L Surgical, we understand your concerns regarding your financing options and endeavour to provide you with ease of mind so you can focus on getting treated.
We strive to ensure we are transparent with our fees and charges and provide you with the financial counselling necessary to understand the costs involved in getting your GERD treated.
Your medical fees and charges may differ depending on the selection of hospitals and bedding arrangements at different medical institutions.
Dr Ganesh Ramalingam can perform the procedure at the following hospitals:
In this minimally invasive procedure, patients might experience less discomfort and scarring and can engage in normal activities more quickly. Laparoscopic anti-reflux surgery / Nissen Fundoplication by Dr Ganesh Ramalingam at G & L Surgical Clinic in Singapore is preferred by patients looking for a reduced recovery period.
Dr Ganesh at G & L Surgical Clinic strives to prioritise his patients’ recovery and comfort. Having had adequate experience in performing advanced laparoscopic anti-reflux surgeries / Nissen Fundoplications for numerous patients for many years in Singapore.
Furthermore, the staff at G & L Surgical Clinic have been thoroughly and adequately trained to make your experience a comfortable and hassle-free one. Whether you intend to undergo our anti-reflux procedures or other medical services in Singapore, you can rest assured that you will be properly and sufficiently cared for by trained professionals. Organise a consultation with our surgeons for further assistance on anti-reflux treatments in Singapore.
Can you ever eat normally after Nissen Fundoplication?
After undergoing Nissen Fundoplication, patients can typically resume eating a normal diet. Patients may be advised to gradually transition from liquids to solid foods. Some patients may also experience difficulty swallowing when eating but this is usually temporary.
What foods to avoid after fundoplication?
Patients should avoid foods that can irritate the oesophagus or cause acid reflux such as spicy, acidic and high-fat foods or alcohol, caffeine and carbonated beverages.
Is your stomach smaller after Nissen Fundoplication?
Nissen Fundoplication does not typically involve any alteration to the size of the stomach. While the size of the stomach is not changed during Nissen Fundoplication surgery, patients may experience changes in their appetite and eating habits after the procedure.
What happens if you eat too much after Fundoplication?
Eating too much after Nissen Fundoplication surgery can cause discomfort and potentially damage the wrap created during the procedure. If the wrap becomes damaged or loosened, patients may experience symptoms of acid reflux, including heartburn, chest pain, and regurgitation. In some cases, additional surgery may be necessary to repair or replace the wrap.
Can I have coffee after fundoplication?
Coffee can cause discomfort or irritation to the oesophagus, particularly in the first few weeks after surgery. Patients should follow their doctor’s post-operative instructions and gradually reintroduce foods and drinks into their diet as tolerated.
I had been experiencing pain in the stomach for a few months but never thought to do anything about it. It was one of the days that I felt unbearable pain and finally got my friend to find a doctor for me.
We found Dr Ganesh and his team online and immediately, we scheduled an appointment with him on the day. Thanks to Dr Ganesh, I got to know I have acid reflux and he recommended some medication for me and within a week I was feeling much better. I am thankful to Dr Ganesh for being kind and patient in his explanation since I have never heard of acid reflux.
He also recommended that I change my diet, which has also helped me feel less discomfort so far. I am forever grateful to his team at G&L Surgical.
Thanks to Lisa, Jiaxin, Ann and Angeline too for assisting me all the way. Keep doing the great work!
I know I have had heartburn for some time but didn’t dare to see a doctor because I heard from friends that you will need to go for surgery to have it treated.
It was one of the days when I started feeling the symptoms again but this time the pain on my chest was quite unbearable. I immediately scheduled an appointment with Dr Ganesh following a friend’s referral and I am so thankful that I got to meet him.
He was very assuring, telling me that there are different options apart from surgery that can treat my condition and that it is not true that all acid reflux needs to be treated with surgery. I was so thankful to know that and I asked him all the questions and he managed to answer them patiently.
Turns out, my condition is not that serious yet but I will need to change what I eat so that it will not trigger my symptoms.
Dr Ganesh’s staff was also very helpful, I left my medication at the clinic and they immediately got someone to send it over to my house too. This is really great service and a clinic that cares for their patients.
If you are finding a reliable doctor that can be trusted, go look for Dr Ganesh and his team.
Dr Ganesh is one of the best doctors you can find. I have severe acid reflux and the previous doctors I saw were unable to help me. First time I saw him, he already knew what to do.
He reviewed my condition and recommended that I undergo a nissen fundoplication surgery, at that time I have no idea what it was but he patiently explained it to me. I felt an affinity and thank God for pointing Dr Ganesh to me.
I underwent the surgery and everything went well. Now I am in my second week of recovery and Dr Ganesh is still patiently finding out if I am recovering well on all the reviews.
If you are looking for a caring and professional doctor that will be with you throughout the journey, he is the one you are looking for. Thank you to Dr Ganesh and his team, thank you to Lisa, Jiaxin, Ann and Angeline, all these lovely angels who help do great work for the patients.
Dr Ganesh is a kind, compassionate and patient doctor. I have been having acid reflux for a month and got to know I have GERD after a gastroscopy with him. Dr Ganesh was very nice, he explained all the questions I have regarding the condition and assured me that it can be treated.
I was afraid of undergoing a major surgery but through his recommendations, I underwent a laparoscopic nissen fundoplication, which he assured me is less invasive. Thanks to him, I feel much better and it has been 3 weeks since I had the operation.
Everything is getting better so far, and i no longer feel any of the symptoms, although there are some changes to my lifestyle, I couldn’t be more thankful to Dr Ganesh. Thank you to the nurses at G&L too for all your kind assistance.
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