Nissen Fundoplication is a surgical procedure to treat gastroesophageal reflux disease (GERD). This surgery is also performed to repair a hiatal hernia.

GERD occurs when stomach contents reflux and enter the lower end of the esophagus (LES) due to a relaxed or weakened sphincter. GERD is treatable disease and serious complications may occur if left untreated.

A hiatal hernia occurs when part of your stomach slides through the diaphragm, the muscular sheet that separates the lungs and chest from the abdomen, and protrudes into your chest cavity. A hiatal hernia is more common and affects people of all ages. A hiatal hernia may not cause any symptoms but patients may experience chest pain, heartburn, belching, and hiccups. A hiatal hernia may contribute to GERD and can result in severe heartburn.

Surgical Procedure

Nissen Fundoplication is performed as day surgery either in the hospital or outpatient surgery center usually with the patient under general anesthesia.

Dr. Nusbaum uses a needle to inject a harmless gas into the abdominal cavity near the belly button to expand the viewing area of the abdomen giving the surgeon a clear view and room to work. The 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. Additional small incisions may be made for a variety of surgical instruments to be used during the procedure.

During the procedure, your surgeon will repair a hiatal hernia first. A hiatal hernia is corrected by bringing your stomach down into your abdominal cavity. Sometimes, your surgeon may use a type of mesh to repair it. Your surgeon then wraps the upper part of the stomach, the fundus, around the lower esophagus to create a valve, suturing it in place. This surgery strengthens the sphincter and helps prevent stomach acid and food from flowing back into the esophagus.

The laparoscope and other instruments are removed and the gas released.

The tiny incisions are closed and covered with small bandages.

Laparoscopy is much less traumatic to the muscles and soft tissues than the traditional method of surgically opening the abdomen with long incisions (open techniques).