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MORE ABOUT GASTRO-ESOPHAGEAL REFLUX DISEASE (GERD)

& LAPAROSCOPIC NISSEN FUNDOPLICATION

HEARTBURN:
QUESTIONS & ANSWERS
GERD, ACID REFLUX,
HIATAL HERNIA
MEDICAL THERAPY
OF GERD
SURGICAL THERAPY
OF GERD
LAPAROSCOPIC
NISSEN
FUNDOPLICATION
LAPAROSCOPIC NISSEN
FUNDOPLICATION:
TECHNIQUE

S.A.G.E.S. GUIDELINES FOR SURGICAL TREATMENT OF GERD

LAPAROSCOPIC NISSEN FUNDOPLICATION


GARTH H. BALLANTYNE, M.D., M.B.A.
F.A.C.S., F.A.S.C.R.S.
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
NEW LONDON, CT 06320

PRACTICE LIMITED TO LAPAROSCOPIC SURGERY


LAPAROSCOPIC NISSEN FUNDOPLICATION


CONTACT US AT:
1-860-444-7675

This page last updated: September 11, 2010 10:35 AM

MORE INFORMATION ABOUT ADVANCED LAPAROSCOPIC SURGERY

HOMECENTER (CALS)ROBOTICS IN LAPAROSCPYLINKSLAPAROSCOPY
Dr BALLANTYNECOLECTOMYHERNIA REPAIRGALLBLADDERALT MEDICINE

MORE INFORMATION ABOUT GERD

HEARTBURN:
QUESTIONS & ANSWERS
GERD, ACID REFLUX,
HIATAL HERNIA
MEDICAL THERAPY
OF GERD
SURGICAL THERAPY
OF GERD
SAGES GUIDELINES FOR SURGICAL TREATMENT OF GERDLAPAROSCOPIC NISSEN
FUNDOPLICATION:
TECHNIQUE

 

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 suturing instruments.

 

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 exquisite detail.

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 open procedure.

 

Before Surgery

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.

 

Your Recovery

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 following surgery.

The surgical incisions will be barely visible a few months after the procedure.


 MORE INFORMATION:
CALL 1-860-444-7675
or browse these other pages:

  • GARTH H. BALLANTYNE, M.D. - BACKGROUND AND TRAINING Dr. Ballantyne's background, training, academic career and clinical experience are outlined. In addition a full list of his PUBLICATIONS and LECTURES are inluded on linked web pages. Finally, the INSURANCE PLANS in which Dr. Ballantyne participates are indicated on another linked page.
  • LAPAROSCOPIC SURGERY - A new type of surgery that decreases the size of incisions used by surgeons that causes less pain and speeds recovery compared to traditionsl surgical techniques. It is also called Keyhole Surgery, Band Aid Surgery and Minimally Invasive Surgery
  • CENTER FOR ADVANCED LAPAROSCOPIC SURGERY - A new state of the art laparoscopic surgery center at a major university teaching hospital in Manhattan. Our Center is based at St. Luke's-Roosevelt Hospital Center which is a Teaching Hospital of Columbia University College of Physicians and Surgeons.
  • AN OVERVIEW OF LAPAROSCOPIC GASTROINTESTINAL SURGERY - Results and complications of diagnostic and therapeutic laparoscopy are regiewed. Topics include esophageal, gastric, hepatobiliary, small bowel and colorectal laparoscopic surgery procedures.
  • LAPAROSCOPIC COLECTOMY - Laparoscopic removal of a part of the colon for diverticulitis, colon cancer, rectal cancer, colorectal cancer, Crohn's Disease, Chronic Ulcerative Colitis, rectal prolapse, volvulus, sigmoid volvulus, cecal volvulus or constipation.
  • LAPAROSCOPIC CHOLECYSTECTOMY - Surgical removal of the gallbladder for gallstones, cholelithiasis, acute cholecystitis, chronic cholecystitis, choledocholithiasis, biliary colic or common bile duct stones.
  • LAPAROSCOPIC INGUINAL HERNIA REPAIR - Surgical repair of inguinal hernia, femoral hernia, double hernia, recurrent hernia, groin hernia, indirect hernia or direct hernia.
  • GASTRO-ESOPHAGEAL REFLUX DISEASE (GERD) - Hiatal hernia, heartburn, acid reflux, Barrett's esophagus, reflux esophagitis, or esophageal stricture.
  • THERAPY OF GASTRO-ESOPHAGEAL REFLUX DISEASE - Treatment of hiatal hernia, heartburn, acid reflux, reflux esophagitis, Barrett's esophagus or esophageal stricture.
  • LAPAROSCOPIC NISSEN FUNDOPLICATION - Surgical repair of a hiatal hernia, acid reflux or heartburn.
  • WHICH IS ALTERNATIVE MEDICINE? TRADITIONAL WESTERN MEDICINE, MODERN EXPERIMETAL MEDICINE or LAPAROSCOPIC SURGERY.
  • 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