The most prevalent gastrointestinal (GI) problems are chronic heartburn and GERD. Genetics, health conditions, lifestyle choices and certain substances can all affect the lower esophageal sphincter (LES), which connects the esophagus to the stomach. When the LES no longer functions correctly, stomach acid and regurgitated food can backflow into the esophagus, causing heartburn and reflux symptoms. Anti-reflux surgery methods can improve LES function for long-term GERD relief.
Why Anti-Reflux Surgery Is Best Conducted by a GI Specialist
When performed correctly, the Nissen fundoplication and hiatal hernia repair techniques are the most dependable, successful and safest anti-reflux surgery methods. In addition, with the introduction of laparoscopy, the GI surgeon now has excellent visibility of the gastro-esophageal architecture. As a result, the distal esophagus is now more accessible to total mobilization for improved LES function and long-term GERD relief. Unfortunately, esophageal mobilization is a critical step in reflux surgery that many general surgeons may overlook.
Why Revisional GERD Surgery is Sometimes Necessary
Chronic GERD causes the esophagus to slowly and gradually retract into the chest. Hiatal hernia surgery aims to reverse this progression and restore normal anatomy before conducting the fundoplication. The most common reason for anti-reflux surgical failure is incomplete esophageal dissection and mobilization, which results in wrap migration into the chest or slipped fundoplication. It is the second most common reason for anti-reflux surgery failure.
Nissen fundoplication and hiatal hernia repair operations that fail necessitate surgical revision. Laparoscopic revision surgery is preferred over open trans-abdominal surgery because it provides improved visualization and shorter recovery times. However, conversion to an open technique is occasionally required due to extensive scar tissue formation, inflammation and loss of normal tissue planes.
Revision GERD surgery is a complex procedure. Therefore, a patient must have an experienced and highly qualified GI surgeon like Dr. Shouhed operate.
Revisional GERD Surgery Benefits
Patients who have undergone GI surgery and are still experiencing severe abdominal pain, nausea, heartburn, dysphagia to solids, regurgitation and vomiting may benefit from revisional foregut surgery. Conditions that necessitate revisional surgery substantially impact a patient’s life, resulting in a failure to flourish, weight loss and a poor quality of life. Following a thorough evaluation and testing, Dr. Shouhed can determine whether a patient requires revisional GERD surgery.
Dr. Danny Shouhed has performed many revisional GERD surgeries. In JAMA Surgery, he presented one of the lengthiest series of Collis Gastroplasty, fundoplication and hiatal hernia repair performed worldwide with outstanding outcomes. Please contact him or visit our Los Angeles office with any questions or concerns or if you suffer from chronic GI issues. Schedule your consultation so he can determine your treatment options for a long-term solution to provide relief.
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