About Acid Reflux Surgery

The first step to treating acid reflux begins with a discussion between you and your doctor. While medication can effectively treat the symptoms for most patients, it won’t resolve the underlying cause of acid backing up from the stomach. When acid reflux symptoms cannot be resolved by medication, surgery, on the other hand, can repair the defects or abnormalities that lead to the problem. Acid reflux surgery has been shown to provide long-term relief in about 95% of patients.^{45, 65} Evidence suggests that it may actually restore normal function to the barrier between the stomach and the food pipe (esophagus), which normally prevents acid from backing up. Surgery may also improve other acid reflux related illness, such as asthma.^{73, 59}

How Acid Reflux Surgery Is Performed

Acid reflux surgery repairs the physical problems, such as a defective lower esophageal sphincter and/or a hiatal hernia that is the root cause of the condition. During the procedure, the surgeon wraps the top part of the stomach, called the fundus, around the esophagus. This works to strengthen the barrier that keeps stomach acid and other digested food from splashing, or “refluxing,” back up into the pipe. If a hiatal hernia is present, it can be repaired as well.

For more than 50 years, acid reflux surgery has been performed using traditional “open” procedures, which require large incisions. With the advancement of technology and the development of new techniques, there are now minimally invasive options (with small incisions) that are just as effective.^{65, 66} These approaches reduce the pain and scarring from the procedure and may speed the recovery process. Minimally invasive procedures are now becoming the standard for acid reflux surgery.²¹

Traditional Acid Reflux Surgery

In traditional “open” acid reflux surgery, the surgeon:

• Makes a 7- to 9-inch incision in your abdomen and thoracic area.
• Wraps the top of the stomach, also called the fundus, around the esophagus and keeps it there with sutures.
• Closes the incision with sutures or surgical staples.

Minimally Invasive Acid Reflux Surgery

In minimally invasive acid reflux surgery, the surgeon:

• Makes ¾-inch incisions (four or five) in the abdomen.
• Inflates the abdomen with air or carbon dioxide for better visibility.
• Inserts a miniature camera called a laparoscope into the abdomen through one of the incisions, and watches the images on a video monitor.
• Uses advanced, long-handled instruments inserted through the other incisions to wrap the fundus (top of the stomach) around the esophagus.
• Closes each small incision with a few stitches.

Benefits of Minimally Invasive Procedure (MIP) for Acid Reflux Surgery

• Usually less pain after surgery.⁶⁷
• Less scarring.
• A shorter hospital stay – The reduction in length of stay for MIP patients compared to open surgery patients is 2.5 to 6 days.²⁰
• A faster recovery and return to normal activities – MIP patients generally return to work 18 to 27 days sooner than open surgery patients.²⁰

You should speak with your surgeon about a minimally invasive option for your surgery. Minimally invasive acid reflux surgeries are not for everyone. For example, if you have had previous abdominal surgery, you may not be a candidate for this type of procedure.

Talking to your Surgeon about Acid Reflux Surgery

Once you’re referred to a surgeon, it is important to ask questions. Learn as much as you can about your surgeon, the surgery, and your own condition. Here are a few questions for you to get the conversation started.

• Are you board certified?
• What procedure would you recommend for acid reflux surgery?
• Would minimally invasive surgery be appropriate in my case?
• How many times have you performed this procedure?
• What have the outcomes been?
• What are complications and side effects of this procedure?
• What should I do to prepare for surgery?
• What can I expect following surgery?
• What type of diagnostic evaluation is a patient required to undergo prior to surgery?
• Will I be referred to another physician for the diagnostic procedure?

Don’t like the answers you get? Consider getting a second opinion. It’s important that you feel comfortable with the treatment and the surgeon you’ve selected.

Finding a Surgeon

To locate a surgeon in your area experienced in minimally invasive procedures for acid reflux surgery, use our Find a Surgeon tool.