Surgery to fix gastroesophageal (acid) reflux can be extremely rewarding and life changing for patients. However, it is very important to select patients who are likely to benefit from surgery, as all operations have complications.
The classic symptoms of reflux are heartburn and regurgitation. Surgery has been shown to be extremely beneficial in eradicating these symptoms and getting a good long-term result for patients. There are many atypical symptoms of reflux so one should never recommend surgery unless good that their symptoms are, in fact, due to reflux. If, however, a patient is shown to suffer from severe reflux and symptoms cannot be controlled with simple antireflux medication, then surgery can be extremely effective in giving patients a very good long-term result in terms of curing their reflux.
The operation is performed laparoscopically (keyhole surgery). There are two components to the operation. The first is to fix any hiatal hernias that may be present. A hiatal hernia means the upper part of the stomach is protruding through the diaphragm muscle into the chest. It is not dangerous but is often associated with reflux. The second and critical part of the operation is called fundoplication. This means that the upper part of the stomach (fundus) is wrapped around the lower part of the oesophagus (gullet) to create a small high pressure zone, to prevent stomach acid from refluxing into the gullet, where it does not belong. The operation normally requires a two day stay in hospital, with a very quick recovery. Dr Andrew Russell is a strong believer that anti-reflux surgery is extremely beneficial to patients, providing that surgeons are cautious on selecting patients who will benefit from having the surgery performed.