Other Names: gastroesophageal reflux disease(GERD), reflux

Indications: Gastroesophageal reflux is the washing of gastric juice up into the esophagus (food tube from the mouth). Almost all people have some reflux as many people get heartburn after a large fatty meal. Only severe reflux associated with symptoms or complications needs to be treated. Reflux may be treated with medicines, thickening of feeds, and keeping the child upright for an hour after eating. If the medical treatment does not work then surgery may be needed. A nissen fundoplication may be recommended when the patient has: severe heartburn that is not responsive to medicines, severe inflammation of the esophagus from the backflow of gastric fluid into the esophagus, narrowing of the esophagus (esophageal stricture), chronic inflammation of the lungs (pneumonia) from frequent breathing in (aspiration) of gastric fluids, or blue spells from aspiration of gastric fluids into the lung.

Laparoscopic Fundoplication: Fundoplication for the management of symptomatic gastroesophageal reflux (GER) is another procedure that has evolved recently taking advantage of minimally invasive technique. Indications for performing either the open or laparoscopic fundoplication are the same. Gastrostomy can be done concomitantly for those children who have feeding problems in addition to the reflux.

Expectations after surgery: Fundoplication is a safe, effective operation. Reflux is eliminated in 95% of patients.

Convalescence: Patients may need to spend 3 to 7 days in the hospital after surgery. A tube will be placed into the stomach through the nose and throat (nasogastric tube) during surgery and may remain for a few days. Small, frequent feedings are recommended.