Nissen fundoplication is also commonly known as Lap Nissen. It was named after Dr. Rudolf Nissen, who developed the procedure in 1950.
This surgery is performed only if other medical treatments have failed to provide any relief to GERD patients.
What Is a Nissen Fundoplication?
Lap Nissen is a laparoscopic procedure used for treating gastroesophageal reflux disease and Hiatal hernias. The primary objective of the surgery is to tighten the junction between the esophagus and the stomach. It helps to prevent reflux of acid.
What is GERD?
GERD is also referred to as chronic acid reflux. Gastroesophageal reflux is a digestive system disorder that affects the esophagus. In this condition, acid-containing contents in your stomach persistently flow back up through the esophagus. The esophagus is the tube that is present between your mouth and stomach. It is part of your gastrointestinal system.
Who Needs Nissen Fundoplication?
Doctors usually recommend making lifestyle changes to the patients experiencing GERD. These changes include a healthy diet, avoiding alcohol, and losing weight. They also prescribe over-the-counter neutralizing medication to alleviate the symptoms. Lap Nissen is considered a last line of treatment. Specialists suggest this surgery to the patients if they do not get any relief from the traditional medical treatment.
What Kind of Tests Are Needed Before Considering a Nissen Fundoplication?
Before Lap Nissen surgery, your surgeon will ask you to undergo some tests to examine the condition of your stomach and esophagus. These tests may include GI X-rays, esophageal manometry, and pH probe. Doctors may also recommend having echocardiography (ECG), chest x-ray, or blood tests.
These tests are helpful for specialists to assess and evaluate any narrowing in the esophagus. Your healthcare provider will also suggest some tests to diagnose hiatal hernia as it can worsen GERD symptoms.
How Painful Is Nissen Fundoplication?
It is a minimally invasive procedure in which patients experience minimal discomfort. The recovery rate is usually fast. After carefully analyzing your condition, the specialist will suggest whether to undergo this surgery to relieve GERD symptoms or not.
How Is Nissen Fundoplication Performed?
As this surgery is performed laparoscopically, large incisions are not required. Surgeons will make tiny incisions to access the stomach and esophagus. During the surgery, a thin tube will be inserted into them. This tube has a camera on end. The camera allows surgeons to see the internal structure of the abdomen. The doctor will wrap the fundus around the bottom of the esophagus (upper section of their stomach). It will help to prevent acid from coming back up.The operation lasts for three to four hours. Depending on the recovery rate, a hospital stay can last between one to three days.
What Are the Benefits of a Nissen Fundoplication?
After having LNF, many people feel a reduction in acid reflux problems. It helps to alleviate the symptoms of GERD. Patients start leading a comfortable and pain-free life. Relieving GERD lessens the chance of developing Barrett’s esophagus. Barrett’s esophagus increases the risk of having esophageal cancer. People who have undergone Lap Nissen also experience fast recovery and shorter hospital stays.
Associated Risks and Complications of Laparoscopic Nissen Fundoplication
With any procedure, there are chances of complications to occur. The biggest concern of this surgery is that symptom alleviation does not always last for long. After 2 to 3 years, some people require another surgery. Like all other operations, this surgery also carries a risk of infection at the incision site. Some other associated complications with this surgery include:
- Bleeding at the surgical site.
- Dysphagia (difficulty in swelling) occurs due to the tight or high wrapping on your esophagus.
- Difficulty belching.
- Peritonitis (infection in the abdomen)
- Unintentional slipping of the wrapped part of your stomach may occur. As a result, the lower esophageal sphincter is no longer supported.
- Perforation or tear in the lining of the esophagus.
How Long Does it Take to Recover from a Laparoscopic Nissen Fundoplication?
A patient undergoing Lap Nissen needs to stay in the hospital for two days. Surgeons recommend patients take a soft foods diet for the first ten to fifteen days. People can continue doing their routine activities within two to three weeks. But doctors suggest avoiding performing any strenuous activities. Restrictions on movement can vary depending on the severity of the patient’s condition.
Can a Nissen Fundoplication Fail?
Laparoscopic Nissen fundoplication is one of the most common procedures used to treat GERD. The failure rate of LNF is from 2% to 30%. In some cases, patients need to undergo one more surgery.
The surgery usually failed due to technical errors or poor surgical technique. It happens due to the slipping of the wrapped part of your stomach. Persistent occurrence of reflux symptoms indicates the failure of the surgery