Gastrointestinal health issues have been gaining a lot of space on the world stage, and gastroesophageal reflux, one of the most well-known diseases of the digestive system, is by far one of the most discussed today.
Even being one of the most common diseases, gastroesophageal reflux, like any other disease, even when treated correctly, can cause the patient to maintain symptoms, requiring surgical intervention, such as reflux surgery.
This is exactly what we are going to discuss from now on.
In this article, we will tell you everything about this type of surgery. How it is recommended to treat gastroesophageal reflux and how it acts in relieving the main symptoms of reflux.
Ready?
Understanding the causes of reflux
Just to be clear, acid reflux or gastroesophageal reflux is simply the return of stomach content or gastric juice to the esophagus, in a region located just below the throat.
Normally this is caused by the dysfunction of the valve (sphincter) located between the esophagus and the stomach. Popularly speaking, when a person has reflux, they feel that unpleasant sensation of heartburn or burning in this region, caused by the return of gastric juice.
This all happens due to an anatomical alteration of the person or the malfunctioning of the sphincter, which is a ring of muscles located between the esophagus and the stomach, whose function is to release food into the stomach and prevent the return of gastric juice.
However, reflux can be related to other factors, such as:
- Excessive alcohol consumption;
- Caffeinated beverages;
- Carbonated drinks;
- Consumption of high-fat foods;
- Constant use of medications;
- Smoking.
- Obesity
Another very important detail is that in addition to these causes, reflux can occur due to other digestive system diseases such as hiatal hernia, for example.
When is reflux surgery necessary?
As in most cases of disease that require surgical intervention, reflux surgery is requested when the control and repair treatment with the use of medications does not show significant improvements.
The initial and standard clinical treatment is the use of medications for the control of reflux symptoms, however, when the reduction of symptoms or control does not occur, or the patient presents complications (below) it is ideal to discuss the need for surgical treatment.
This is because reflux can trigger other more serious diseases, for example:
- Changes in the mucosa;
- Stenosis;
- Intestinal metaplasia (Barrett’s Esophagus)
- Bleeding;
- Ulcers;
- Cancer.
For this reason, at the slightest sign of persistence of symptoms, the patient should be reevaluated, their treatment optimized, and still, if the alterations persist, consider surgical intervention.
Types of surgical procedures for reflux
There are three types of surgical procedures that can be used to correct reflux, such as:
- Conventional surgery;
- Videolaparoscopy;
- Robotic surgery.
Conventional surgery
This is a surgery with a cutting technique in the upper part of the abdomen, however, a technique that is rarely used today due to the advantages that other methods provide.
Videolaparoscopy
In this procedure, the surgeon makes small incisions in the upper region of the abdomen, through which forceps, scissors, and a small camera will be inserted.
The camera is precisely for detailed visualization of the location, allowing precision in the stages of the surgery.
A positive point of this procedure is that it inhibits uncontrolled bleeding and complications, as well as significantly minimizing the patient’s hospitalization and recovery time, enabling a quicker return to their daily activities.
Robotic surgery
This is the most modern technique for performing gastroesophageal reflux surgery.
It is also performed with incisions in the upper region of the abdomen, however, it has the support of a robot guided by the surgeon to perform precise movements, providing more safety to the patient.
Despite this, the most used procedure for correcting reflux, including being the least invasive than open surgeries and providing a faster recovery, is the fundoplication or Nissen surgery, performed with the videolaparoscopy technique.
This type of surgery technique is so simple that, generally, the patient is discharged from the hospital one day after the procedure.
Incredible, isn’t it?
How does reflux surgery work?
Whatever the technique used in reflux surgery, its operation follows the same standard.
Check out the steps with me…
- It is performed in a hospital environment properly prepared;
- The patient always receives general anesthesia;
- Small cuts or incisions are made in the upper part of the abdomen for the passage of surgical instruments.
- With the camera, the entire altered structure is checked.
- The patient’s stomach is released from its adhesions, and sutured around the esophagus, as if it were a tie (Nissen Technique).
- This tie is loose around the esophagus but allows anatomically reinforcing the entrance of the stomach, preventing acid return to the esophagus.
This surgery is considered safe and quick, with an estimated duration of 1 to 1.5 hours.
Recovery and potential risks of reflux surgery
The initial guidance for any surgery is complete rest in the first few days after the procedure, keep the incision site always clean and dry, and rigorously administer the prescribed painkillers for the postoperative period.
However, in this case, it is recommended to perform small walks to restore strength in the incision region and also to avoid sitting or lying down for too long.
The most common risks are bleeding at the procedure site, the appearance of edema, and finally infections, which are an eventual risk for most surgical procedures.
Conclusion
It’s interesting how for every type of disease there is always a specific treatment and even a surgical procedure, like the reflux surgery we talked about earlier.
And as care for the digestive system is in vogue, seeking reliable information can make a big difference.
If you are looking for solid, reliable information in an uncomplicated and practical way, Gastroblog is what you need.
Gastroblog is a perfect site for people who want to be in the know about all matters of the digestive system, as its goal is to provide access to true information, granted by specialists in the digestive system.
Don’t stay curious, come and learn much more with us.
We await you.
A hug.
Image by Sasin Tipchai from Pixabay
Doutor em Gastroenterologia pela FM-USP.
Especialista em Cirurgia do Aparelho Digestivo (HCFMUSP), Endoscopia Digestiva (SOBED) e Gastroenterologia (FBG).
Professor do curso de Medicina da Fundação Educacional do Município de Assis - FEMA.
Médico da clínica Gastrosaúde de Marília.