GASTRO-ESOPHAGEAL REFLUX DISEASE (GERD)
& LAPAROSCOPIC NISSEN FUNDOPLICATION
GARTH H. BALLANTYNE, M.D., M.B.A.
SURGEON IN CHIEF
BOARD CERTIFIED IN:
GENERAL SURGERY & COLON AND RECTAL SURGERY
OFFICE: 4 SHAW'S COVE, SUITE #201
NEW LONDON, CT 06320
SURGEON IN CHIEF
LAWRENCE & MEMORIAL HOSPITAL
PRACTICE LIMITED TO LAPAROSCOPIC SURGERY
LAPAROSCOPIC NISSEN FUNDOPLICATION
CONTACT US AT:
This page last updated:
September 11, 2010 10:35 AM
MORE INFORMATION ABOUT ADVANCED LAPAROSCOPIC
MORE INFORMATION ABOUT GERD
Nissen fundoplication (NIS sen FUN do pli KA shun) is a procedure that alleviates
chronic heartburn in people whose condition cannot be controlled by either lifestyle
changes or medication. Their symptoms are caused by severe gastroesophageal reflux
due to a weak valve muscle between the stomach and the esophagus. They experience a
burning sensation from the chest to the throat whenever stomach acids are forced back up
into the esophagus.
If you are one of these people, Nissen fundoplication offers a good chance of overcoming
a condition that affects many areas of life-from what and when you eat, to how well you
sleep and what you wear. In fact, a recent study found that 90 percent of patients
undergoing the procedure are symptom-free after 10 years. However, because
laparoscopic Nissen fundoplication requires extensive and highly specialized training, only
a few surgeons in the United States perform the procedure.
At the Center for Advanced Laparoscopic Surgery at St. Luke's-Roosevelt Hospital
Center, patients benefit from the expertise of a leading laparoscopic surgeon and the
latest laparoscopic surgery technology. Highlights include three dimensional imaging, the
most advanced ultrasound equipment currently available, and new internal laparoscopic
Advantages of the Laparoscopic Nissen Procedure
First performed by Dr. Rudolph Nissen in 1951, Nissen fundoplication has traditionally
been performed as an open surgery procedure requiring an incision of 6 to 10 inches long.
Patients were normally hospitalized for about 10 days, and recuperation required up to
two months. Because of the large abdominal incision, recovery entailed significant pain.
Today, however, Nissen fundoplication can be performed laparoscopically. Because the
new approach requires only five small incisions, patients experience minimal pain and
recover faster. The laparoscope, which is a telescopic videocamera, gives a better view of
internal organs than can usually be achieved in a traditional open procedure. Magnified
images viewed on the video monitor reveal internal structures, including blood vessels, in
Patients lose less blood during laparoscopic surgery than during traditional surgery, and
they experience fewer infections and other complications as a result of surgery. In a week
or two, patients can return to work.
Strengthening the Stomach Valve
Whether Nissen fundoplication is accomplished traditionally or laparoscopically, the
procedure is the same. To prevent stomach acids from being forced back into the
esophagus, Dr. Ballantyne must strengthen the "valve" between the stomach and the
esophagus. He accomplishes this by wrapping the upper portion of the stomach, or fundus,
around the bottom of the esophagus.
About 40 percent of all patients needing Nissen fundoplication have hiatal hernias, a
condition that contributes to the burning sensation that patients may experience in their
chest, throat, and jaw. Although this condition alone cannot cause gastroesophageal
reflux, Dr. Ballantyne repairs the hernia before proceeding with the wrap.
Following the operation, surgical tape or stitches close the incisions.
In a small percentage of cases-about one in 50 (about 2 percent) - Dr. Ballantyne is
unable to complete the Nissen fundoplication laparoscopically, and must revert to the
Not all patients with heartburn need or can benefit from Nissen fundoplication. Before the
procedure is recommended, Dr. Ballantyne will carefully evaluate your condition. This
may require a sensitive test that monitors your heartburn over a period of time. If the
procedure can help, Dr. Ballantyne will discuss the benefits, risks, and possible
complications of the operation.
A pre-admission evaluation, including routine blood testing, is completed within five days
of the procedure. It provides your surgeon with important information about your health
before the operation. Generally, St. Luke's-Roosevelt Hospital Center conducts this
evaluation. However, under certain circumstances, your personal physician may complete
the necessary pre-admission tests.
You will be admitted to the hospital the day before or the same day as your surgery.
Before the operation, an anesthesiologist will meet with you.
Because laparoscopic Nissen fundoplication is performed under general anesthesia, you
cannot eat or drink anything after midnight the day before the surgery.
In the hours following the operation, you will experience some pain from the small
incisions your surgeon made to perform the procedure. After three or four days, you can
expect to return home, where you will be able to take care of yourself.
Within a week or so of leaving the hospital, you can resume your normal schedule,
including returning to work. You can also resume fitness programs and sports competition.
Dr. Ballantyne will, however, place you on a soft foods diet for up to three weeks
The surgical incisions will be barely visible a few months after the procedure.
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Copyright 1996, Garth Hadden Ballantyne, M.D., P.C. All rights reserved.
50 East 69th Street, New York, New York 10021 (212)-249-2626 or (800)-LAP-SURG