Surgical Institute Navicent Health

Reflux Surgeries

Illustration of a woman having chest pains

Gastroesophageal Reflux Disease (GERD) and Acid Reflux

Acid reflux is the result of acid flowing backward through the esophagus from the stomach, which then produces symptoms such as heartburn. If you have prolonged or acute acid reflux, this is called GERD.

Diet and lifestyle changes can help slight or serious reflux symptoms and there are medications that provide relief to your symptoms. These types of medication are both prescription and over-the-counter and include:

  • Antacids
  • H2 blockers
  • Proton pump inhibitors (PPIs)

Medication and lifestyle changes don't help everyone with acid reflux and, sometimes, surgery will be an option. Surgery will help to repair or replace the valve that is at the lower part of the esophagus that keeps acid from coming back up from the stomach. This area is named lower esophageal sphincter (LES) and a weak or damaged LES is the cause of GERD.

GERD that is untreated can cause a condition called Barrett's esophagus, which increases your risk of esophageal cancer. Esophageal cancer is rare, though, even for people that have Barrett's.

When to Consider Surgery

It may be recommended that you have surgery if you have acute GERD complications such as your stomach acid causes inflammation of your esophagus. Inflammation can cause bleeding or ulcers and any scars from these wounds can then tighten your esophagus, which will make swallowing difficult.

Surgery will only be recommended when changing your diet and lifestyle and medications do not work. There are several options for surgery that might relieve your GERD symptoms. There are pros and cons to the surgery. There are the benefits that it will help you avoid long-term medications and it can help you stop complications like inflammation of the esophagus. The downside of the surgery includes cost and some recovery times may take up to six weeks before you can return to work.

Types of Acid Reflux Surgeries

Fundoplication

This is the most common GERD surgery. This will shrink and reinforce the LES. The surgeon will wrap the upper part of your stomach around the lower esophagus to support the sphincter. It can be performed either as typical surgery where the surgeon makes an incision in your stomach or as a laparoscopic surgery which will involve several small incisions and is less invasive. Fundoplication has a very good long-term success rate.

Transoral Incisionless Fundoplication (TIF)

When fundoplication is not an appropriate option, this procedure is used instead. The procedure produces a barrier in between the esophagus and the stomach, which then stops acid reflux. One of the benefits of this procedure is that it does not require incisions. The EsophyX tool is placed in your mouth and produces several folds at the bottom of the esophagus. These folds then form a new valve. This can be a great option since it does not require incisions if medication is not relieving your GERD.

Stretta Procedure

This is an outpatient procedure that is performed with an endoscope, which is a thin and flexible tube that is threaded into your esophagus. An electrode will heat your esophageal tissue and produce small cuts in it. These cuts will then form scar tissue in the esophagus and block the nerves that respond to acid reflux. The create scar tissue will also help to tighten the surrounding muscles. This procedure is still new so we are unaware of what the long-term results are; however, it has proven to be effective at relieving and, in some cases, eliminating GERD symptoms. This is a less expensive option that fundoplication but you should still check with your insurance to see what is covered.

Bard EndoCinch System

An endoscope is also used for this system. Pleats are formed with stitches in the LES, which strengthens it. This is not as common a procedure as there are others listed but it is another option to relieve your GERD symptoms. Not all insurance carriers cover this procedure so it is important to check out the costs before deciding on this procedure.

Linx Surgery

A special device called a linx is used in this surgery, which is a ring of small magnetic titanium beads. When the beads are enclosed around the LES, the linx then strengthens the sphincter. Since the beads are magnetized, they will move together and keep the opening that is in between the stomach and esophagus shut so food can move through your stomach as it normally does. This is also a good option since it is minimally invasive surgery and the recovery time is usually a lot less than regular surgery. This surgery also has less reported pain than regular surgery. It is still a new procedure but has shown good results in relieving GERD pain.

Recovery

Each surgery has a different type of recovery. It just depends on how invasive it was and if it was laparoscopic or traditional. There is a quicker recovery period with laparoscopic surgery with less pain than traditional surgery. Open surgery, like fundoplication surgery, requires a week stay in the hospital and as much as six weeks rest. The laparoscopic fundoplication surgery will only require a couple of days in the hospital and around one week of rest. It also has less reported pain than traditional surgery.

Outlook

After having one of the acid reflux surgeries to treat GERD, the prognosis is usually very good with most people having relief from and sometimes elimination of their symptoms. Some of the newer surgeries have not had enough time to gauge their long-term success.