What is fundoplication?

Fundoplication is a surgery to treat gastroesophageal reflux disease (GERD). GERD occurs when the muscles of the esophagus do not close the opening to the stomach tightly enough. This causes reflux in which stomach contents back up into the esophagus. Fundoplication involves wrapping the upper part of the stomach around the bottom of the esophagus to tighten the stomach opening.

Fundoplication is also known as anti-reflux surgery. Reflux can cause chronic heartburn, vomiting, coughing and wheezing. Fundoplication can lessen or fully prevent reflux. It may be an option for you if medications and lifestyle changes have not improved reflux.

Fundoplication is a common but major surgery with significant risks and potential complications. You may have less invasive treatment options. Consider getting a second opinion about all of your treatment choices before having fundoplication. 

Why is fundoplication performed? 

Your doctor may recommend fundoplication to treat severe gastroesophageal reflux disease (GERD) that damages the esophagus. GERD occurs when the muscles of the esophagus do not close the opening to the stomach tightly enough. This causes reflux in which stomach contents back up into the esophagus. GERD is characterized by chronic heartburn, vomiting, coughing and wheezing. 

Fundoplication also treats hiatal hernia, a condition in which part of the stomach pushes up through an opening in the diaphragm called the hiatus.

Your doctor will only consider fundoplication if other treatment options that involve less risk of complications have been ineffective, such as medication.  Ask your doctor about all of your treatment options and consider getting a second opinion before deciding on fundoplication.

Who performs fundoplication?

A general surgeon performs fundoplication. General surgeons specialize in the surgical care of diseases, injuries and deformities affecting the abdomen, breasts, digestive tract, endocrine system and skin. 

How is fundoplication performed?

Your fundoplication will be performed in a hospital. Your surgeon will make a large incision or series of small incisions in your upper abdomen. The upper part of the stomach is wrapped and stitched around the bottom of the esophagus. This tightens and reinforces the opening of the esophagus and prevents stomach contents from backing up into the esophagus. 

Surgical approaches to fundoplication

Your surgeon will perform a fundoplication using one of the following approaches:

  • Laparoscopic fundoplication is minimally invasive surgery. It involves inserting special instruments and a laparoscope through three or four small incisions in the upper abdomen. The laparoscope is a thin, lighted instrument with a small camera. The camera sends pictures of the inside of your body to a video screen that your surgeon sees while performing surgery. Another surgery option is to pass an instrument called an endoscope through your mouth and into your esophagus. Your surgeon sees the inside of your stomach on the video screen while tightening the end of your esophagus with stitches. Minimally invasive surgery generally involves a faster recovery and less pain than open surgery. This is because it causes less trauma to tissues and organs. Your surgeon will make small incisions, or no incisions at all, instead of a larger incision used in open surgery. Surgical tools are threaded around muscles and tissues instead of cutting through or displacing them as in open surgery.
  • Open surgery involves making a larger incision in the upper abdomen. An open surgery incision allows your doctor to see and access your stomach directly. Open surgery allows your doctor to directly see and access the surgical area. Open surgery generally involves a longer recovery and more pain than minimally invasive surgery. Open surgery requires a larger incision and more cutting and displacement of muscle and other tissues than minimally invasive surgery. Despite this, open surgery may be a safer or more effective method for certain patients.