Minimally Invasive Acid Reflux Surgery
Gastroesophageal reflux disease (GERD) is a common disorder that affects an estimated 21 million people in the United States. Many of those people go untreated because they don't know that the symptoms may signal a more serious condition. It is a condition in which food or liquid travels backwards from the stomach to the esophagus. This can irritate the esophagus, causing heartburn and other symptoms. GERD is often chronic, which means that once you develop this condition, you may experience recurring episodes for the rest of your life. An estimated 10-20% of people will have acid reflux at least once a week.
Causes & Risk Factors
Anyone, including infants and children, can have GERD. Causes and risk factors for GERD can include: hiatal hernia (part of the stomach moves above the diaphragm - the muscle separating the chest and abdominal cavities), scleroderma and obesity; smoking and alcohol may also increase the risk of GERD.
GERD can also be brought on or worsened by pregnancy and medications for certain conditions (seasickness, asthma, heart disease, high blood pressure, Parkinson's disease, excessive menstrual bleeding, insomnia and depression).
Symptoms
You may feel burning in the chest or throat, also known as heartburn. Sometimes, you can taste stomach fluid in the back of the mouth. This is known as acid indigestion. If you have these symptoms more than twice a week, you may have GERD and may be a candidate for a surgery called Fundoplication using the surgical robot. Other symptoms of GERD can include:
- Feeling that food may be left trapped behind the breastbone
- Increased heartburn when bending, stooping, lying down, or eating
- Nausea after eating
- Difficulty swallowing
- Regurgitation of food
Treatment
In many cases, changing your diet and taking over-the-counter antacids can reduce the frequency of GERD symptoms. If symptoms persist after these lifestyle changes, more intensive drug therapy may be required. Patients who cannot control their symptoms with these approaches may choose to have surgery.
If it is not treated, GERD can lead to more serious health problems. In some cases, you might need medication or surgery.
Surgery
Nissen fundoplication is a surgical procedure used to treat severe GERD. During fundoplication surgery, the upper curve of the stomach (known as the fundus) is carefully wrapped around the junction of the esophagus and stomach and sewn into place. This creates a barrier that prevents the flow of acid into the esophagus.
Nissen fundoplication can be done as either traditional "open" surgery or a laparoscopic procedure. The open procedure involves an incision of about 8 inches in the abdomen, while the laparoscopic approach is a minimally invasive technique using significantly smaller incisions.
Robot-Assisted Surgery
Timpanogos Regional Hospital offers the latest approach to treating GERD -- robot-assisted Nissen fundoplication surgery with the da Vinci Surgical System. Benefits of da Vinci surgery include:
- Significantly less pain
- Potentially less blood loss
- Fewer complications - including reduced risk of infection
- Less scarring – 1-2 cm incisions versus 8 inches with open surgery
- Shorter hospital stay
- Quicker recovery from surgery and return to normal routine
The state-of-the-art da Vinci robot allows some complex surgeries to be performed as minimally invasive procedures. Through tiny 1-2 cm incisions, a surgeon using the da Vinci system can operate with precision and control while minimizing the pain that often accompanies the large incisions associated with open surgery. The surgeon uses special hand controls to guide robotic arms that hold specially designed surgical instruments. The latest computer technology converts the surgeon’s large hand movements into precise small movements, resulting in tremendous dexterity. The robotic "wrists" can rotate a full 360 degrees, enabling your surgeon to control the miniature surgical instruments with unprecedented accuracy, flexibility, and range of motion. The da Vinci System requires that every surgical maneuver be performed with direct input from your surgeon – the machine cannot move on its own.
The three-dimensional, high definition da Vinci camera supplies your surgeon with a magnified view of the internal organs that’s better than normal vision. The enhanced visualization and greater degree of movement offered by the da Vinci System provides a minimally invasive alternative that offers many advantages for Nissen fundoplication surgery.
Lifestyle / Dietary Changes
Some GERD patients have found that following lifestyle and dietary changes can ease their symptoms:
- Avoid bending over or exercising just after eating
- Avoid foods and beverages that trigger symptoms
- Avoid clothes or belts that fit tightly around your waist
- Do not lie down with a full stomach
- Do not smoke
- Eat smaller meals
- Lose weight, if you are overweight
- Reduce stress
- Sleep with your head raised about 6 inches (tilt entire bed, or use a wedge under your body, not just with normal pillows)
