ANTI REFLUX SURGERY

None of the patients required readmission or felt the need to stay longer. Our observations indicate that with a proper selection criterion, laparoscopic nissen Rossetti fundoplication can be offered as anti-reflux therapy to the patient as a day care procedure.

Surgical intervention is considered when no adequate symptom relief has been achieved with other treatment methods. Currently, two primary surgical procedures for GERD treatment are the Laparoscopic Nissen Fundoplication (Lap Nissen) and the LINX procedure.

Doctors are still divided over it. But the new technique known as Endoscopic Suturing, used for the treatment of Gastroesphagal Reflux Disease (GERD), is now being employed for treating patients in the city for the first time. Yet for some people, despite medication and lifestyle changes, heartburn persists in the form of chronic acid reflux. In severe cases, the lower esophageal sphincter (LES) may actually be weakened; allowing the acids from the stomach to flow upwards into the lower esophagus.

Pain following this surgery is usually mild, but some patients may need pain medication. Some patients are instructed to limit food intake to a liquid diet in the days following surgery. Over a period of days, they are advised to gradually add solid foods to their diet. Patients should ask the surgeon about the post-operative diet. Such normal activities, as lifting, work, driving, showering, and sexual intercourse can usually be resumed within a short period of time.

Circumferential resection of the mucosa is avoided to prevent stricture formation as was noted in initial few cases of this series. Any bleeding during the procedure is controlled by coagrasper (Fig. 6D, E). In the only published pilot study including 10 patients, there was reduction in EAET and improvement in flap valve grade observed on endoscopic examination. In addition, all the patients could discontinue PPI after the ARMS therapy [47]. No alternative medicine therapies have been proved to treat GERD or reverse damage to the esophagus.

This is a surgery to reinforce the lower esophageal sphincter. It is achieved by tightening the valve of the esophagus using three or four minor cuts in the abdomen and inserting a flexible tube with a camera for laparoscopy. 57.

This was a very painful procedure and involved at least 5-7 days in hospital, plus a long recovery period. The same procedure is now performed laparoscopicaly, using what is popularly known as the keyhole approach. The operation is performed through 5 small puncture holes instead of through a large incision, and involves usually only an overnight stay in hospital though some patients may be discharged home on the same day. With the increasing prevalence of GERD, there is an unmet need for minimally invasive treatment modalities for patients who do not respond to PPIs and are unwilling for ARS.

This reduces the operative time and also decreases the blood loss in the surgery. In normal individuals this would even add to decreased postoperative pain since the dissection is less than the nissen fundoplication procedure.

Lower esophagus sphincter LES valve closes when food passes from esophagus to stomach. When LES does not close properly the food and acid from the stomach flows back to esophagus and this is known as GRED. GRED can be caused by hiatal hernia also which means protruding of small intestine or stomach through an enlarged opening of the diaphragm. Our panel of Doctors consists of basics specialists of General Physicians, General Surgeons, Obstetricians, Gynaecologists, Anaesthesiologists, ENT specialists, Pediatricians, Orthopedicians, Dermatologists, Ophtholmologists of Laparoscopic Surgeons, Laparoscopic Gynecologists, Infertility Specialists, Bariatric (Obesity) Surgeons, Gastroenterologists, Intensive Care Specialists, Arthroscopic Specialists, Joint Replacement Specialists, Cardiologists, Neurologists, Neuro Surgeons, Pulmonologists, Vascular Surgeons, Endocrinologists and Plastic Surgeons, Neonatologists.

The last decade has witnessed the fall and rise of many endoscopic devices for GERD. Major endoscopic strategies include radiofrequency ablation and endoscopic fundoplication devices. Current endoscopic devices score high on subjective improvement, but have been unimpressive in objective improvement like esophageal acid exposure.

However, esophageal cancer is rare, even in people with Barrett’s. SevenHills Hospital is a leading multi super-specialty tertiary care hospital established in 1986 and has been a premier healthcare services provider for more than three decades. Built on sprawling area of 17 acres, this world-class facility has 1500 beds with over 30 super-specialties offering excellent outpatient and inpatient facility. The hospital has maintained par excellence in quality of clinical care and safety standards, and is dedicated in providing the best possible medical services. There is an in-campus residential facility for doctors and medical support staff which can accommodate more than 300 experts, thereby assuring round the clock availability for experts for consultation.

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