The Techniques And Results Of GERD Laparoscopic Surgery

Gastroesophageal reflux disease (GERD) is a common condition that gastroenterologists often come across. Patients usually ignore GERD, thinking it to be normal acid reflux, without knowing that the symptoms are much more complicated.
GERD is actually a severe form of acid reflux. It is a disorder that is characterised by the repeated flowing of the stomach’s gastric content into the esophagus, leading to troublesome symptoms. GERD is classified into two types: the presence of reflux symptoms without detection of any esophageal erosions in the endoscopic examination (NERD) or reflux symptoms present with esophageal-related disorders. (ERD).
ERD is very common in patients with GERD, with around 20% prevalence, resulting in inflammation and pain. The major complications associated with persistent GERD symptoms are erosive oesophagitis, ulceration, strictures, and gastrointestinal (GI) bleeding. Though the use of proton-pump inhibitors reduces the amount of acid produced in the stomach, they do not improve the symptoms for all patients.
For such individuals, GERD laparoscopic surgery or Nissen fundoplication is the standard treatment, which is preferred over open surgery due to its high efficacy, low mortality rates and better cosmesis.

Typical And Atypical Symptoms Of GERD

The typical symptoms of GERD include heartburn and regurgitation. Patients often feel a burning sensation in the retrosternal area, behind the breastbone.
The condition is also present with atypical symptoms like non-cardiac chest pain and extraesophageal syndromes like chronic cough, asthma, laryngitis and dental erosions. In 50% of the patients, GERD is present with associated syndromes such as dyspepsia, bloating, abdominal pain and disturbed bowel movements.

Surgical Management Of GERD

GERD laparoscopic surgery is highly effective in curing PPI-responsive and non-PPI responsive patients. More than 90%—80% of the patients have reported getting relief from symptoms like heartburn and a burning sensation in the chest with a follow-up in 10 years and 20 years, respectively. In rare cases, some patients have experienced a recurrence of the disease; still, the reflux is not as severe as it was before the surgery.
The procedure involves making small incisions during which the surgeon wraps the stomach around the lower part of the esophagus to prevent the backward flow of the contents.

Though GERD surgery reduces the reflux symptoms, there are few patients who experience side effects such as dysphagia and bloating. To reduce post-operative issues, a variety of procedures like the Toupet fundoplication, consisting of a posterior (270°) wrap, and the Dor fundoplication, consisting of an anterior (180°) wrap have been proposed to decrease the likelihood of such issues.

Who Is Eligible For GERD Laparoscopic Surgery?

Patients are eligible for GERD laparoscopic surgery if they fall under the following categories.

1. Patients who are intolerant of PPI medications
2. Patients with persistent acid reflux symptoms.
3. Patients with failed medical management, like severe symptoms that are not controlled with acid-suppression medications.
4. Patients who want a permanent solution for GERD
5. Patients who experience additional esophageal syndromes like asthma, cough and hoarseness.

Conclusion

If you want to undergo GERD laparoscopic surgery, you can get in touch with Dr. Purnendu Bhowmik. He is a skilled gastrosurgeon who has transformed the lives of many patients suffering from GERD.