Your doctor has recommended that you undergo surgery to treat reflux disease. But what does that actually mean? Your diaphragm is a muscle that separates your chest from your abdomen and helps you to breathe. Normally, the diaphragm has an opening for the esophagus to pass through where it connects with the stomach. At this point, the ring-like layer of muscle which acts as a one-way valve sometimes becomes lax. When you have reflux disease, the weakened muscle allows the contents of your stomach to back up into your esophagus. Patient Education This can cause considerable discomfort, often worse at night, with symptoms like heartburn, difficulty swallowing, chest pain and belching. Reflux disease is often caused by a hiatal hernia, pregnancy, an ulcer or tumor of the esophagus. About half of the patients with severe Reflux Disease often have a hiatal hernia, which is a tear in the diaphragm. Your Procedure: On the day of your operation, you will be asked to put on a surgical gown.
You may receive a sedative by mouth and an intravenous line may be put in. You will then be transferred to the operating table. The anesthesiologist will begin to administer anesthesia – most probably general anesthesia. The surgeon will then apply antiseptic solution to the skin around the area where the incisions will be made, place a sterile drape around the operative site. After allowing a few minutes for the anesthetic to take effect a small incision is made above the umbilicus; then, a hollow needle will be inserted through the abdominal wall. And the abdomen will be inflated with carbon dioxide. An umbilical port is created for the laparoscope.
Four more incisions will be made, with care taken to keep the openings as small as possible. Once in place, the laparoscope will provide video images, so the surgeon can insert the instruments used to locate and pull back the liver in order to see the upper part of the stomach. Then, the surgeon cuts away the tissue that connects the liver and the stomach. Then the surgeon divides and separates the arteries that supply blood to the top of the stomach. After freeing the stomach from the spleen, your doctor wraps the upper portion of the stomach around the esophagus and sutures it into place. A rubber tube is placed in the esophagus to keep the wrap from becoming too tight. All of the instruments are withdrawn the carbon dioxide is allowed to escape the muscle layers and other tissues are sewn together and the skin is closed with sutures or staples.
Finally, sterile dressings are applied.
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