Gastroesophageal Reflux Disease (GERD) Surgery

GERD surgery is known as fundoplication, a procedure that strengthens the valve between your stomach and your esophagus. There are several types of GERD surgery, including: Laparoscopic surgery, a minimally invasive procedure with small incisionsOpen surgery through a large incisionTransoral Incisionless Fundoplication (TIF) surgery through a tube, with no incision required. Hancock Regional Hospital is one of only a few hospitals in Indiana offering TIF surgery.

Minimally invasive surgeries involve smaller incisions and a less-invasive technique, shortening recovery time.

You might consider GERD surgery if more conservative approaches to dealing with acid reflux have failed and you’re continuing to experience symptoms, including sore throat, chronic cough, swallowing difficulty, interruption of your sleep, or a vocal disorder. Ask your doctor if GERD surgery might benefit you.

Most patients report some bloating after GERD surgery, and some report difficulty swallowing and/or diarrhea. Possible side effects of GERD surgery include an inability to belch, burp, or vomit, which may lead to bloating and flatulence. These symptoms should lessen over time.

Many more conservative approaches can help you effectively manage acid reflux, the most conservative being changes in diet. Eating less-spicy and greasy foods, alcohol, and carbonated beverages can help. You can try eating smaller meals and cutting out late-night snacking. Losing weight and stopping smoking can help with acid reflux. There are also medications to treat acid reflux; ask your doctor if one may be right for you.

GERD surgery has a high success rate; about 95% of patients no longer need medication to treat their acid reflux after surgery.

Your health insurance provider may require you to get a referral from your primary care provider to see a surgeon about GERD surgery.

You can always get a second or third opinion, but it isn’t required.

Your health history will be compiled and available to the team before, during, and after surgery. If you’re a Hancock Health patient, we will be able to access your records within our system. If you aren’t, we’ll work with your doctors to get the necessary information.

Consult the Price Transparency Tool at HancockRegionalHospital.org for an idea of how much GERD surgery might cost.

Medicare parts A and B will cover the cost of GERD surgery, but it’s important for your doctor to indicate that the surgery is medically necessary.

You’ll be instructed not to eat anything after midnight on the day of your surgery, and you might also be told to stop taking certain medications or dietary supplements.

You’ll arrive an hour before your surgery and be escorted to the preoperative waiting area.You’ll remove all of your clothing and jewelry, and put on a hospital gown. (Your valuables will be placed in a secure area or may be given to a family member.) You’ll sign any necessary paperwork and a preoperative nurse will take your vital signs, review your medications, and answer any questions.You’ll meet your surgery team and they’ll mark the location of the surgery on your body. An I.V. (intravenous line) will be placed in your hand or arm, so medications—including general anesthesia—can be administered.When it’s time for your surgery, you will be wheeled into the operating suite on a stretcher.

In addition to the surgeon, you have an anesthesiologist, nurses—some of them specialize in working with patients and others assist the surgeon—and support staff, who will check you in and out, compile your records, and more. They all work together, performing their individual jobs, so the procedure is as successful as possible.

If you’re having TIF surgery, you’ll probably go home the same day, but you might want to bring an overnight bag just in case. Laparoscopic and open fundoplication procedures will require a hospital stay: two or three nights for laparoscopic surgery and four to six nights for open surgery. If you’re having one of these procedures, you should bring everything you’ll need for that time, including changes of underwear, glasses or contacts, headphones, and your medications.

Fundoplication involves wrapping a part of the stomach around the base of the esophagus and tightening it with stitches to reinforce the valve and keep stomach acid where it belongs. If you’re having laparoscopic GERD surgery, your surgeon will make small incisions in your abdomen, one of which is for a tiny video camera through which the surgeon will view the procedure on a monitor. Tools are inserted through the other incisions to perform the operation, and your incisions will be sutured. If you’re having open GERD surgery, your surgeon will make one larger incision in your abdomen, pull back muscle and tissue, and perform the procedure, then suture the incision. The surgeon may insert a tube into your stomach to stabilize the stomach wall. The tube will be removed in about a week. If you’re having the TIF procedure, a flexible tube will be inserted through your mouth, which will allow the surgeon to perform fundoplication with special tweezers and fasteners, without making any incisions.

GERD surgery typically takes two to three hours.

TIF surgery is an outpatient procedure. You should expect to spend two or three days in the hospital following laparoscopic GERD surgery and up to six days following open GERD surgery.

Immediately following surgery, you’ll spend time in the recovery room and receive pain medication. If you’ve had TIF surgery, you’ll be released when you’re feeling well; you may have a sore throat or some minor chest pain. If you’ve had a laparoscopic or open procedure, you’ll be taken to your hospital room where you will be able to see friends or family who came with you.

You’ll be able to talk to your surgeon after your procedure, in the recovery room or your hospital room.

In most cases, patients receive pain medication immediately following surgery.

You may be prescribed pain medication, anticoagulants, antibiotics, and/or other symptom-reducing medications after surgery.

You should be able to return to fairly normal activity, including going up and down stairs, after your GERD surgery. Follow all postoperative instructions provided by your surgeon, including and especially all dietary restrictions. You should be able to return to a normal diet within a few weeks. Daily walks should help you in your recovery, but you should avoid strenuous exercise for a couple of weeks after surgery. Avoid lifting heavy objects for two to four weeks after surgery.

You’ll have an appointment with your surgeon about two weeks after your surgery to check on results and discuss any issues you might be having.

You’ll need fresh dressings but you won’t need antibiotic ointment, as putting it on the incisions is unnecessary.

Call your doctor if you experience fever or chills; redness, bleeding, or discharge around an incision; problems swallowing; or nausea or vomiting for more than 24 hours.