Anti-reflux surgery

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This page will give you information about anti-reflux surgery. If you have any questions, you should ask your GP or other relevant health professional.
What is acid reflux?
Acid reflux is a condition where acid from your stomach passes up into your oesophagus (gullet). If this happens too often it can cause symptoms of a burning sensation in your chest (‘heartburn’) or acid in the back of your mouth. The acid can cause the lining of your oesophagus to become inflamed (oesophagitis) or scarred.
What are the benefits of surgery?
This surgery aims to improve your reflux symptoms. You should get relief from symptoms of acid reflux and no longer need to take medication.
Are there any alternatives to surgery?
Avoiding foods that make your symptoms worse, especially late at night can help ease your symptoms. Raising the head of the bed can also help. If you are overweight, it may help to lose weight.
Medication that lowers the acid content in your stomach is effective at controlling symptoms and healing the inflammation in your oesophagus.
There is a surgical alternative to a fundoplication called a LINX™ procedure. This involves placing magnetic beads around your oesophagus to form a valve effect.
Surgery is only recommended if medication does not help, you have side effects from anti-acid medication or if you would prefer to have an operation than take medication for the rest of your life.
What does the operation involve?
The operation is performed under a general anaesthetic and usually takes 1 to 2 hours.
Your surgeon will hold your liver out of the way and free up the upper stomach and lower oesophagus, along with the muscular part of your diaphragm.
They will stitch your diaphragm to reduce the size of the hole your oesophagus passes through.
Your surgeon will wrap and stitch the top part of your stomach around your lower oesophagus, to produce a valve effect.
How can I prepare myself for the operation?
If you smoke, stopping smoking now may reduce your risk of developing complications and will improve your long-term health.
Try to maintain a healthy weight. You have a higher risk of developing complications if you are overweight. Your surgeon may suggest you follow a special diet for 2 weeks before the procedure to reduce the size of your liver. The liver is a large organ that needs to be lifted to perform the surgery safely. If it is smaller, the risk of complications such as bleeding are reduced.
Regular exercise should help to prepare you for the operation, help you to recover and improve your long-term health. Before you start exercising, ask the healthcare team or your GP for advice.
If you have not had the coronavirus (COVID-19) vaccine, you may be at an increased risk of serious illness related to COVID-19 while you recover. Speak to your doctor or healthcare team if you would like to have the vaccine.
What complications can happen?
Some complications can be serious and can even cause death.
General complications of any operation

bleeding
developing a hernia in the scar or port site
infection of the surgical site (wound)
allergic reaction to the equipment, materials or medication
blood clot in your leg
blood clot in your lung
chest infection
death

Specific complications of this operation
Keyhole surgery complications

damage to structures such as your bowel, bladder or blood vessels
developing a hernia near one of the cuts
surgical emphysema (a crackling sensation in your skin caused by trapped carbon dioxide)
gas embolism

Fundoplication complications

pneumothorax, where air escapes into the space around your lung
making a hole in your oesophagus or stomach (perforation)
tear of the stitches used for the wrap
damage to your liver
damage to your spleen
difficulty swallowing for a few months

Long-term problems

continued difficulty swallowing where you cannot swallow most foods normally
incomplete control of reflux symptoms
weight loss
abdominal discomfort
diarrhoea
tissues can join together in an abnormal way

Consequences of this procedure

pain
scarring of your skin

How soon will I recover?
You may be able to go home the same day or the next day.
You should be able to return to work after a few weeks, depending on your recovery and the type of work you do.
Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, ask the healthcare team or your GP for advice.
You should make a full recovery, with the symptoms of acid reflux gone or much improved.