Having surgery

A Nissen fundoplication is surgery to treat severe gastro-oesophageal reflux disease (GORD). We do this surgery if it is not possible to control long-term (chronic) acid reflux symptoms with medicine or lifestyle changes.

During a Nissen fundoplication, we wrap the top part of your stomach around the lower part of your food pipe (oesophagus). This makes a new valve. The valve controls acid reflux by stopping the acid in your stomach flowing back into your food pipe.

You usually have keyhole (minimally invasive or laparoscopic) surgery under general anaesthetic. This is a medicine that makes you sleep during the procedure and stops you feeling anything.

Pre-assessment appointment

Before your surgery, you have a pre-assessment appointment in the outpatient anaesthetic clinic.

You see a nurse or anaesthetist (a doctor who gives anaesthetic medicine to people in hospital). They:

• ask you about any previous illnesses, treatments or operations (your medical and surgical history)
• find out which medicines you take
• check your blood test results

This appointment allows us to make sure that you are fit enough and ready for surgery.

We also ask about your home arrangements and if you have anyone to look after you when you go home after surgery.

We explain how prepare for your surgery and general anaesthetic, including:

• when to stop eating and drinking before your surgery
• which medicines you can take and which you might need to stop temporarily

After your pre-assessment appointment, our booking team contacts you with a date for your surgery. They also tell you where to go on the day of your surgery.

During a Nissen fundoplication

You usually have keyhole (minimally invasive or laparoscopic) surgery. The procedure normally takes about 1 hour to 1 hour 30 minutes.

The surgeon makes 4 to 5 small cuts in your tummy (abdomen). They insert instruments through these cuts to do the surgery.

We use a harmless gas (carbon dioxide) to inflate your tummy and make space for the surgery. This gas leaves your body naturally after the procedure.

The surgeon wraps the top part of your stomach around the lower part of your food pipe. This tightens the closing ring of muscle at the lower end of the food pipe and creates a one-way valve. The new valve stops stomach acid flowing back into your food pipe.

If part of your stomach slides up into your chest (hiatus hernia), this can also cause acid reflux symptoms. We repair any hiatus hernia during Nissen fundoplication surgery.

There is a chance that the surgeon might need to change your procedure to open surgery. If this happens, the surgeon will make a cut across your tummy to do the procedure. The cut is about 15 to 30cm long.

After a Nissen fundoplication

After surgery, you wake up in the recovery area of the hospital. The nurse checks the area around your tummy and your wound sites.

When you are comfortable and your blood pressure is stable, we transfer you to the ward. Here, we:

• monitor your progress
• give you pain medicine
• encourage you to move around

You usually stay in hospital for 1 to 3 days. If you have open surgery, you might need to stay for longer while you recover.