The primary problem in GERD patients is that an esophageal sphincter is either too short or too loose. By taking a section of the patient’s stomach and wrapping it around the current sphincter, Dr Sanjoy Mandal effectively reconstructs the sphincter, developing the longest and tightest sphincter possible. The Nissen is unique in that it is a complete Fundoplication procedure, which means that instead of a 270-300 degree plication like the TIF, the Nissen allows for a full 360-degree stomach wrap around the LES (lower esophageal sphincter). This strengthens the sphincter and prevents food from splashing back up, says the best gastrointestinal surgeon in Kolkata.
The lap Nissen Fundoplication is one of the most well-known and well-established anti-reflux surgeries available, and it is a great choice for patients, especially those with more serious GERD. The only major variations between this technique and the TIF are the degree to which the plication is done and the invasiveness of the procedure.
Pros
- With over 60 years of evidence on the procedure’s longevity, it is one of the most researched anti-reflux procedures.
- After the treatment, 90-95 percent of patients with heartburn will be able to stop taking their normal heartburn medication.
- It is effective for GERD symptoms other than heartburn, while certain procedures are only effective for heartburn.
- According to the best gastroenterology surgeon in Kolkata, patients do not need to be weaned off their medications; after treatment, they simply avoid taking them.
Cons
- The most invasive of all the anti-reflux treatments is the Lap Nissen. However, it is done laparoscopically, and so there is very little scarring.
- Bloating after surgery will last for months.
- For certain patients, dysphasia (difficulty swallowing) may last up to 6-8 weeks after the operation.
Recovery after Lap Nissen Fundoplication
Patients are expected to remain in the hospital overnight after surgery for observation. You will be on a liquid diet for two weeks after surgery, then a semi-solid diet for weeks three and four, before returning to a completely unlimited diet by eight weeks. Patients are also advised to take two weeks off work after the operation.
It can be difficult to choose the best anti-reflux procedure for you, which is why it is important to understand not just how each one functions, but also the different benefits, drawbacks, recovery specifics, and costs associated with each one. The good news is that GERD patients do not have to make these choices alone. Dr Sanjoy Mandal, recognized gi surgeon in Kolkata, is always available to guide you through your choices.