Fundoplication
Anti-Reflux Surgery
Fundoplication is a surgical procedure performed to restore the function of the oesophagus and stomach to alleviate the symptoms of Gastro-Oesophageal Reflux Disease (GORD/GERD).
The anti-reflux operation is called a fundoplication, because the top part of the stomach called the "fundus" is tightened ("plicated") around the oesophagus. This in turn creates an anti-reflux valve mechanism.
Often a small part of the stomach is pushed up into the chest, known as a hiatus hernia, and can create further discomfort such as chest pain and heartburn. This needs to be addressed during the operation by a hiatus hernia repair.
The surgery is performed as a key-hole operation by an upper gastrointestinal surgeon.
Recovery after Fundoplication
The surgery involves a general anaesthetic and you are expected to stay in hospital 1 or 2 nights. You will have small laparoscopic (key-hole) port site wounds which will have dressings and dissolving sutures underneath. You can shower after surgery and pat them dry as these are waterproof. If the dressings get soaked then they can be replaced. You are encouraged to mobilise and sit out of bed which will help with your recovery and also prevent complications. It is common to feel some shoulder tip pain and this should subside over 24 hours. Regular pain relief such as paracetamol will be provided to you and short-term use of non-steroidal anti-inflammatories (eg. ibuprofen) or sometimes stronger opioids. After surgery, it is recommended that you don't drive for 1 week and avoid heavy lifting for 4 weeks. A medical certificate can be provided to you.
Diet after Fundoplication
The usual routine is to progress your diet gradually from thin fluids to a soft diet over the course of a few weeks. This is to ensure that you are able to tolerate the food going down the newly tightened oesophagus and stomach and also allow the food to empty out of the stomach effectively. It is very important to avoid any nausea or vomiting, as this can threaten the newly repaired anti-reflux valve. Anti-nausea medications will be provided to you in case you need them. After surgery, it is common for the oesophagus and stomach to become swollen. Changing of the texture and food type can help to reduce pain, discomfort and bloating.
As a general rule, you will be on 2 weeks of fluids, 2 weeks of puree and 2 weeks of soft diet post operatively. Please discuss your dietary requirements with Dr Lah for any clarification. The key concept is to eat and drink slowly, with frequent smaller meals. This will ensure that the oesophagus and the stomach do not get over stretched during the healing process. Please avoid soft drinks or carbonated drinks as they may potentiate the feeling of gas bloat. Please sit upright when eating and chew all foods well, down to smaller pieces.
Stage/Texture examples:
Fluid diet - Anything that will flow if left on a flat surface. eg. juice, smoothie, yoghurt, custard, ice-cream, strained soup, Sustagen/Up & Go
Puree diet - Blended food. eg. pureed or mashed vegetables, blended meat, fish and poultry.
Soft diet - Any food that will crumble or easily become soft. eg. canned fruit, banana, pear, eggs, lentils, tofu, fish, stewed meats
Things to avoid - Bread, dried fruit, raw nuts or seeds, dry meat/fish, hard lollies, potato chips, popcorn