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Frequent questions 

How is Gastroesophageal Reflux treated?

Gastroesophageal reflux is usually treated in  progressive steps:

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Changes in lifestyle

In many cases, a change in diet and taking over-the-counter antacids can reduce the frequency and severity of your symptoms. Losing weight, reducing or eliminating smoking and alcohol consumption, and changing eating and sleeping habits can also help.

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Surgery  

Patients who do not respond well to lifestyle changes or medications, or who continually require medications to control their symptoms, will need to learn to cope with their condition or may undergo a surgical procedure. Surgery is very effective in treating gastroesophageal reflux.

There are procedures that are currently in a trial stage, known as intraluminal endoscopic procedures, which are alternatives to laparoscopic surgery and open surgery. You will need to speak with your surgeon and doctor to decide if you are a candidate for any of these procedures.

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What are the Advantages of the Laparoscopic Method?

The advantages of the laparoscopic approach are that it generally provides:

  • Reduction of post-operative pain

  • A shorter hospital stay

  • A faster return to work

  • Better cosmetic result

 

Are You a Candidate for Laparoscopic Surgery?

Although laparoscopic antireflux surgery has many benefits, it may not be the best option for some patients. 

Cirugía 

Los pacientes que no responden bien a los cambios en el estilo de vida o a las medicaciones o que continuamente requieren de medicaciones para controlar sus síntomas, deberán aprender a sobrellevar su condición o bien podrán someterse a un procedimiento quirúrgico. La cirugía es muy eficaz para el tratamiento del reflujo gastroesofágico.

Existen procedimientos que actualmente están en una etapa de prueba, que se conocen como procedimientos endoscópicos intraluminales, que son alternativas a la cirugía laparoscópica y a la cirugía a cielo abierto. Será necesario que hable con su cirujano y su médico a fin de decidir si usted es un candidato para alguno de estos procedimientos.

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¿Cuáles son las Ventajas del Método Laparoscópico?

Las ventajas del abordaje laparoscópico son que por lo general proporciona:

  • Reducción del dolor post operatorio

  • Una estadía hospitalaria más breve

  • Un retorno más rápido al trabajo

  • Mejor resultado cosmético

 

¿Es Usted Candidato para la Cirugía Laparoscópica?

Si bien la cirugía laparoscópica antirreflujo presenta muchos beneficios, es posible que no sea la más indicada para algunos pacientes. 

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What Can You Expect Before Your Anti-Reflux Surgery?

  • After your surgeon goes over the potential risks and benefits of the operation with you, you will need to provide a written authorization in order for the surgery to be performed.

  • Pre-surgical preparation includes blood tests, medical evaluation, chest X-ray, and an EKG depending on your age and medical condition.

  • Your surgeon may ask you to completely evacuate your colon and clean your intestines before surgery. You may be asked to only follow a liquid diet for a day or more before surgery.

  • It is recommended that you shower the night before or the morning of surgery.

  • After midnight the night before the operation, you should not eat or drink anything, except the medications that your surgeon has told you that you are allowed to take with a sip of water the morning of the surgery.

  • Drugs such as aspirin, blood thinners, anti-inflammatories (arthritis medications), and vitamin E must be temporarily stopped for several days and up to a week before surgery.

  • Diet medication or St. John's wort [St. John's Wort] for two weeks prior to surgery.

  • Quit smoking and arrange for any help you may need around your home.

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What should I expect the day of the Surgery?

  • He usually arrives at the hospital the morning of the operation.

  • A qualified member of the medical staff will place a small needle / catheter in your vein in order to administer medications during surgery.

  • Presurgical medications are often required.

  • You will be given general anesthesia, and you will fall asleep during the operation, which can take several hours.

  • Following the operation, you will be sent to the recovery room until you are fully awake.

  • Most patients stay in the hospital the night of surgery and may require additional days of hospital stay.

 

How is surgery performed?

  • Laparoscopic antireflux surgery (commonly referred to as laparoscopic Nissen fundoplication) involves reinforcing the “valve” between the esophagus and the stomach by wrapping the lower end of the esophagus with the upper portion of the stomach, resembling the bread that surrounds the stomach. the sausage of a "hot dog" [hot dog, pancho].

  • In a laparoscopic procedure, surgeons use small incisions (one-quarter to one-half inch) to access the abdomen through cannulas (narrow tubular instruments). The laparoscope, which is connected to a small video camera, is inserted through the small incision, giving the surgeon a magnified view of the patient's internal organs on a television screen.

  • The entire operation is performed “in” after the abdomen is expanded by gas being inflated.

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What  happens after surgery?

  • Patients are encouraged to participate in light activities at home after surgery.

  • Postoperative pain is usually mild, although some patients may need to be prescribed some medication to relieve the pain.

  • Anti-reflux medication is usually not necessary after the operation.

  • Some surgeons modify their patients' diet after surgery, starting with a liquid diet followed by gradual progress to solid foods. You should ask your surgeon about dietary restrictions immediately after the operation.

  • You will likely be able to return to your normal activities in no time. Such activities include: taking showers, driving a car, climbing stairs, lifting objects, working, and having sex.

  • Call and ask for a check-up doctor's appointment within two weeks of your operation.

 

Are there Side Effects to this Surgery?

Studies have shown that the vast majority of patients who undergo the procedure are either symptom free or have significant improvement in their GERD symptoms.

  • Long-term side effects from this procedure are generally rare.

  • Some patients experience temporary difficulty swallowing immediately after the operation. This usually resolves between one and three months after surgery.

  • Sometimes, patients may require a procedure to expand the esophagus (endoscopic dilation) or, rarely, a new operation.

  • The ability to burp or vomit may be limited following this procedure. Some patients report that they have a bloated stomach.

  • Although it occurs rarely, some patients report that they have no improvement in their symptoms.

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¿Qué  pasa después de la Cirugía?

  • A los pacientes se les anima que participen de actividades livianas en casa después de la cirugía.

  • El dolor posoperatorio suele ser leve aunque es posible que algunos pacientes necesiten que se les recete alguna medicación para calmar el dolor.

  • Por lo general no hace falta tomar medicación antirreflujo después de la operación.

  • Algunos cirujanos modifican la dieta de sus pacientes después de la cirugía y empiezan con una dieta líquida seguida de un progreso gradual hasta llegar a los alimentos sólidos. Debiera preguntarle a su cirujano acerca de restricciones en la dieta inmediatamente después de la operación.

  • Es probable que pueda volver a sus actividades normales en poco tiempo. Entre dichas actividades se incluyen: darse duchas, conducir el automóvil, subir escaleras, levantar objetos, trabajar y tener relaciones sexuales.

  • Llame y pida un turno médico de control antes de cumplirse las dos semanas siguientes a su operación.

 

¿Existen Efectos Secundarios a esta Cirugía?

Los estudios han mostrado que la vasta mayoría de los pacientes que se someten al procedimiento quedan libres de síntomas o bien tienen una importante mejoría en sus síntomas de reflujo gastroesofágico.

  • Los efectos secundarios a largo plazo de este procedimiento por lo general son poco comunes.

  • Algunos pacientes experimentan dificultad pasajera para tragar inmediatamente después de la operación. Esto suele resolverse entre uno y tres meses después de la cirugía.

  • En ocasiones, es posible que los pacientes requieran de un procedimiento para expandir el esófago (dilatación endoscópica) o en raras ocasiones una nueva operación.

  • Es posible que la habilidad de eructar o de vomitar se vea limitada a continuación de este procedimiento. Algunos pacientes informan que tienen distensión estomacal.

  • Si bien ocurre raramente, algunos pacientes informan que no tienen ninguna mejoría de sus síntomas.

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DESPUES
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