Digestive Topics : Fundoplication
Fundoplication is a surgery to prevent the contents of the stomach from returning to the esophagus. The surgery tightens the lower esophagus to allow food down so that it cannot come back up and cause symptoms of gastro esophageal reflux disease (GERD). For more information about fundoplication and why a child may need it, download the GIKids Fact Sheet on Fundoplication.
What is a fundoplication?
Fundoplication is a type of surgery to prevent stomach contents from entering the esophagus (food tube). This is achieved by wrapping the upper portion of the stomach (fundus) around the lower portion of the esophagus. This tightens the lower esophagus so that food and fluid can go down into the stomach but cannot return up to the esophagus to cause symptoms of gastroesophageal refulx disease (GERD).
Why does a child need fundoplication?
Fundoplication is recommended for children who have complications or persistent symptoms related to GERD that are not impvroved with appropriate medical treatment. Symptoms or complications of GERD where fundoplication can be considered cinlude inflammation of the esophagus (esophagitis), failure to grow, recurrent pneumonia or asthma related to GERD, anemia, and narrowing of the esophagus (esophageal stricture).
How is a fundoplication done?
Fundoplication may be done through a standard surgical incision in the skin on the upper abdomen (open funcoplication) or it may be performed using a small camera (laparoscope) and insruments placed through three to four quarter-inch incisions (laproscopic fundoplication). The operation requires two to three hours to comlete, and recovery time is generally less than a week. Recovery time for an open fundoplication may be longer than for a laproscopic fundoplication.
What happens after fundoplication?
The refulx complications that the child was experiencing prior to surgery are expected to improve. However, many patients still require reflux medications to control symptoms. The child usually needs some time to adjust to the different shape of the stomach and increased tightness at the lower part of the esophagus. This can create symptoms such as gagging and retching with feeds. It is also harder for the child to burp after fundoplication and if a gastrosomy feeding tube is in place, parents learn to open it to relieve the pressure. These problems may be temporary and respond to feeding modification, but they can also become chronic and difficult to manage. Sometimes the fundoplication unwraps, and this can cause recurrence of gastroesophageal reflux. The fundoplication can also herniate or move slightly upward into the chest. If the tymptoms from these events are uncontrollable, the child may need to have the funoplication redone.
For more information or to locate a pediatric gastroenterologist in your area, please visit the NASPGHAN website.
IMPORTANT REMINDER: This information from the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) is intended only to provide general information and not as a definitive basis for diagnosis or treatment in any particular case. It is very important that you consult your doctor about your specific condition.