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Reflux disease is very common in adults with approximately as many as 1 in 4 adults in the US being affected. For many, this disease can be controlled with medications, avoiding caffeine and alcohol, or dietary and lifestyle changes.
“If, however, dietary and lifestyle changes and medications don’t work, surgical intervention is possible,” says Dr. Ryan Bly of Surgical Associates of Neenah. “Surgical intervention is important because it can prevent the progression of precancerous changes to becoming an invasive cancer.”
Patients with uncontrolled reflux or who are interested in reducing or eliminating their acid blocking medication are usually candidates for surgery. People with changes in their esophagus called Barrett’s, which is sometimes precancerous, are also considered. Evaluation for a patient includes an EGD or upper scope to look at the esophagus, stomach and the first part of the intestines. Usually esophageal function is examined with a test called manometry. This is important for surgical planning.
The goal of surgical intervention is to help recreate the division between the esophagus and stomach, which can help keep the gastric contents in the stomach and reduce reflux symptoms. Many times a condition called hiatal hernia causes these symptoms. A hiatal hernia is a hole in the diaphragm through which the esophagus runs. The hole dilates and becomes too large. This lets a part of the stomach slide up into the chest.
Options for surgical repair can include repairing the hiatal hernia, augmenting the sphincter or valve with a magnetic device, or wrapping a small portion of the stomach around the bottom of the esophagus to try to recreate that separation. The valve can also be recreated through the mouth using a special device.
“Historically, these surgeries were done through a larger incision. With the increase in laparoscopic surgeries more than 2 decades ago, minimally invasive surgery has become the gold standard,” says Dr. Bly. “Now, robotic-assisted surgery is increasing in prevalence and rapidly becoming the norm. With robotic-assisted surgery, the recovery is generally less painful, there is usually a greater success rate with controlling reflux, and the need for anti-reflux medications, which can have side effects, is often reduced or eliminated.”
The recovery from surgery, just like groin or belly button hernias, includes lifting restrictions and usually dietary changes for a brief period of time.
If you are in need of reflux or hiatal surgery contact Dr. Bly at Surgical Associates of Neenah. All surgeons at Surgical Associates of Neenah are trained in robotic-assisted surgery which offers our patients reduced recovery time, smaller scaring, and shorter hospital stays. Our surgeons also lead the area’s highest level trauma center. You do not need a referral to contact our surgeons.