Symptoms of reflux, heartburn and regurgitation are some of the common findings of gastro-oesophageal reflux disease. These can be troubling and disabling. The majority of these symptoms can be controlled effectively with medications such as proton pump inhibitors.
On occasion, you may have breakthrough symptoms or circumstances where surgery could be considered. The type of surgery depends on your specific health needs and previous surgeries. Commonly, a keyhole “fundoplication” is performed where the stomach is wrapped around the oesophagus is performed.
Sometimes gastro-oesophageal reflux disease is associated with a hiatus hernia. This is where a portion of the stomach has slipped up into the chest. You can develop different symptoms depending on which part of the stomach has slipped into the chest. Typically the stomach can be brought down into the abdomen as part of a laparoscopic hiatal hernia repair.
Increasingly, reflux is a symptom after weight loss surgery and this is an increasingly complex field, particularly after sleeve gastrectomy since a large part of the stomach has been removed. Cardiopexy and gastric bypass operations can be discussed with Jonathan.
You will normally see Jonathan for a first clinic appointment. Depending on the degree of symptoms, further investigations may be required to establish whether an operation will be effective and to exclude motility disorders. The results are then discussed at the second clinic appointment and together, a decision for surgery is considered.
What happens when your stomach is pulled into your chest?
When this happens then you may have very little symptoms. On the other hand some people are plagued by reflux, swallowing problems and regurgitation. Here, this man had daily regurgitation because the “tunnel” between the chest and abdomen had become enlarged. A visible hole can now be seen.
What this looks like to a surgeon
When the hole is enlarged then the stomach can herniate up into the chest where it does not belong. The negative pressure in the chest and the kinking of the stomach can cause a multitude of symptoms
The stomach is reduced and the tunnel is calibrated back to normal
With keyhole surgery the stomach is returned to the abdomen without tension. The tunnel between the chest and abdomen is tightened back to normal with sutures and then the stomach is folded on itself.
This man lived approximately 4 hours from Perth. He stayed in Hollywood Private Hospital for two days following surgery and returned home with complete resolution of his regurgitation.