Nissen Fundoplication

We often keep a towel or cloth handy when babies are around, in case they spit up, which is common. But acid reflux , or heartburn, can affect older children and teens, also. The formal name of this is gastroesophageal reflux disease, commonly called GERD. WakeMed Physician Practices fPediatric Surgery offers experienced diagnosis and treatment of GERD for children of all ages.

What causes GERD?
When we eat, food moves through the esophagus from the throat to the stomach. If the muscle fibers in the stomach -the sphinfcter muscle--don't close well, food, liquid and stomach acid can leak back into the esophagus. This is called reflux, or GERD.

Some symptoms are:

• Heartburn, gas, abdominal pain, or colicky behavior (frequent crying and fussiness)
• Frequent reswallowing
• Frequent or recurrent vomiting
• Frequent or persistent cough or wheezing
• Refusing to eat or difficulty eating (choking or gagging with feeding)

Acid reflux occurs when digestive acids from the stomach enter the esophagus. Sometimes, incidents of acid reflux can be reduced by changes in diet, especially if children avoid:

• spicy or high-fat foods
• eating within a few hours of going to bed
• juices, carbonated and caffeinated drinks
• acidic foods like tomatoes, citrus and pickles

Often, acid reflux medication can help. But in severe cases of acid reflux, GERD surgery may be needed, particularly when patients have regular symptoms like difficulty swallowing, weight loss, anemia, or bleeding. In serious cases, the esophagus can be inflamed or scarred if the esophageal sphincter (the valve located between the stomach and esophagus) fails to close and stomach acid comes increasingly in contact with the walls of the esophagus.

What is Nissen Fundoplication Surgery?
Named after the doctor who first performed this procedure in 1955, Nissen fundoplication surgery is a generally safe and effective GERD surgery that involves wrapping the upper part of the stomach around the esophagus, and stitching it in place. This creates a barrier so that acid cannot flow from the stomach up into the esophagus.

Nissen fundoplication surgery is increasingly being performed as a minimally invasive procedure, using a laparascope or a da Vinci® Surgical System, which is available at WakeMed. An advantage of laproscopic surgery or computer-assisted surgery is that while performing a Nissen fundoplication surgery, the surgeon does not need to make a long incision. Instead, he or she would make several small incisions, and insert a specialized tiny surgical camera and instruments to perform the surgery precisely and quickly.

Patients who have this far less invasive procedure typically will have less pain and scarring, less blood loss, and a faster recovery time, allowing them to return to normal activities sooner.

Talk to your physician at WakeMed Physician Practices Pediatric Surgery about Nissen fundoplication surgery, and you and your child will be feeling better quickly.