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GERD/Hiatal Hernia/Paraesophageal Hernia

Chronic heartburn can develop into gastroesophageal reflux disease (GERD), a progressive condition that causes worsening heartburn despite treatment with medications. GERD is usually caused when the muscular valve at the lower part of the esophagus (lower esophageal sphincter) becomes defective.

Sometimes there is also an associated hiatal hernia. A hiatal hernia occurs when a portion of the stomach slips up through an opening in the muscle that separates the chest from the abdomen (diaphragm). Chronic GERD can lead to Barrett’s Esophagus, which is a precancerous condition.

The procedure to correct GERD is called a laparoscopic Nissen fundoplication and requires an overnight hospital stay.

Laparoscopic Nissen fundoplication uses a portion of the stomach to wrap the lower esophageal sphincter. This serves to reconstruct the muscular valve and prevent the reflux. If present, the hernia is also fixed at this time. The procedure is performed through five incisions, all less than 1cm in size.

The day after surgery, an esophagram is performed to check the repair. A liquid diet must be started prior to discharge from the hospital.