Surgical Treatment

Peter J. Lydon, MD, FACS
Those people who have continuing symptoms despite lifestyle modification and the prescribed use of appropriate medication should consider an operation to cure their GERD. The most common operation performed, called a fundoplication, involves wrapping the top of the stomach around the esophagus. This is like wrapping a scarf around your neck. The fundoplication creates a higher LES pressure. It does not have to be tight to do this. For almost all people having this operation heartburn ends immediately. Most people do have some difficulty swallowing afterwards. This usually lasts for about 3 – 6 weeks. Essentially all of these procedures are performed laparoscopically today. Patients receive general anesthesia and are fully asleep. The operations typically last about 1 and 1/2 hours. My patients are usually in the hospital 1 – 2 days afterwards. Like patients having laparoscopic gallbladder operations, they are back to their usual activity in less than a week. The risks of the operation are injury to the spleen, liver, esophagus, or stomach, which might result in bleeding or infection. Those injuries are very uncommon and usually correctable. Remotely, the spleen may have to be removed (splenectomy). There is also the risk that the operation might not completely eliminate GERD, that swallowing difficulties might be prolonged, or that you may not be able to vomit when you have to. A full 360-degree wrap is performed in the majority of cases; however, selected patients sometimes have a partial, 270-degree wrap (Toupet Fundoplication), if the esophagus is weaker than normal.

Dr. Lydon has been performing laparoscopic fundoplications since 1992 and was involved in the first procedures done in the region. He has also been a leader in the field and has trained and proctored several surgeons in this procedure. He has been involved in hundreds of cases with a rate of conversion to the “open” procedure of well under 1%. Approximately 90 to 95% of these patients have been cured of their GERD.