Having surgery

Nissen fundoplication for severe acid reflux

A Nissen fundoplication treats severe gastrointestinal reflux disease (GORD). It is used if long-term (chronic) reflux symptoms cannot be controlled with medicine or lifestyle changes .

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

The surgery is usually keyhole (laparoscopic) surgery, and is done under general anaesthetic.

Pre-assessment appointment

Before your surgery, you will have a pre-assessment appointment in the outpatient anaesthetic clinic. You will be seen by a nurse or anaesthetist.

They will take a medical and surgical history from you, check what medicines you are taking, and check your blood tests results. This appointment will make sure you are ready for surgery.

You will also be asked about your home arrangements and if you have anyone to look after you when you get home after surgery.

You will be given instructions about 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 might need to be stopped

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

During a Nissen fundoplication

The surgery is usually keyhole (laparoscopic) surgery. It usually takes 60 to 90 minutes.

The surgeon will make 4 to 5 small cuts in your tummy (abdomen), and use these cuts to insert instruments to carry out the surgery.

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

The surgeon will wrap the top part of your stomach around the lower part of your oesophagus. This tightens the closing mechanism at the lower end of the oesophagus, and creates a one-way valve. This valve stops stomach acid from flowing back into your oesophagus.

If part of your stomach slides up into your chest (hiatus hernia), this can also cause GORD symptoms. A hiatus hernia will be repaired during Nissen fundoplication surgery.

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

After a Nissen fundoplication

After surgery, you will wake up in the recovery area. The nurse will check your recovery and wound sites.

As soon as you are comfortable, and your blood pressure is stable, you will be transferred to the ward. On the ward your progress will be monitored and you will be given pain medicines. You will also be encouraged to move around.

You will usually stay in hospital for 1 to 3 days. If you have had open surgery, this might be longer.

Resource number: 4855/VER2
Last reviewed: June 2022
Next review due: June 2025

Contact us

If you have any questions or concerns about Nissen fundoplication, please contact the benign upper GI clinical nurse specialist.

Phone: 020 7188 2673 Monday to Friday, 9am to 5pm.

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