Advanced Laparoscopic Surgery to Treat Gastroesophageal Reflux Disease – La Jolla
As experts in minimally invasive surgery, the physicians of Surgical Associates of La Jolla are adept at performing laparoscopic procedures. Among the most advanced types of laparoscopic surgery our doctors perform at our La Jolla practice, convenient to both metro San Diego and North County, are the procedures used to treat gastroesophageal reflux disease (GERD) and other conditions that typically afflict patients who suffer from GERD. Contact our practice today to learn more about treating GERD and its symptoms, including heartburn, sour-tasting regurgitation, belching, upper-abdominal pain, and chronic coughing, through laparoscopic surgery.
Gastroesophageal Reflux Disease (GERD)
Gastroesophageal reflux disease, or GERD, is caused by stomach acid and contents that travel up (backward) from the stomach to as far back as the throat. Under normal circumstances, a one-way valve called the lower esophageal sphincter (LES), located at the opening of the stomach, allows food coming down the esophagus into the stomach and keeps the stomach acid from escaping. A weakened LES, however, can allow stomach acid and food to travel back up (reflux).
Treating GERD with Nissen Fundoplication
Many instances of GERD can be treated through various lifestyle changes and/or medications. However, when these non-surgical treatment options fail to bring relief, patients should consider undergoing laparoscopic Nissen fundoplication, which, in essence, recreates the valve between the stomach and esophagus.
The Procedure
The Nissen fundoplication procedure is a laparoscopic surgery performed at Surgical Associates of La Jolla, serving North County and all San Diego. Unlike open fundoplication, in which the procedure is performed through a single large incision, laparoscopic nissen fundoplication is performed through several tiny incisions in the abdomen.
To begin the procedure, the surgeon carefully clears the junction between the esophagus and the stomach, the site of the lower esophageal sphincter. Then, the surgeon wraps the top part of the stomach, the fundus, around the esophagus, where the esophagus and the stomach meet. Depending on the size of the fundus and other factors, the surgeon may choose to make either a "full wrap" (wrapping the fundus all the way around the LES) or a "partial wrap" (wrapping the fundus only part-way around the LES). The wrapped fundus is then stitched permanently into place, providing support for the lower esophageal sphincter and helping to prevent reflux. Most patients also require that a hiatal hernia is fixed at the same time (see below).
Hiatal Hernias
A hiatal hernia occurs when there is an enlarged or weakened section of the hiatus, the opening in the diaphragm through which the esophagus passes. This type of abnormality of the hiatal opening can allow the stomach to protrude into the chest cavity, causing or exacerbating GERD.
Though hiatal hernias can occur in patients not suffering from gastroesophageal reflux disease, the condition does appear in many people with GERD. If that is the case, the surgeon will tighten the hiatus with stitches before the fundoplication surgery.
Often our surgeons will reinforce the suture closure with a synthetic mesh that may reduce the risk of the hernia reoccurring.
Achalasia
Achalasia is a relatively uncommon disease that affects the muscles that make up the esophagus. People who suffer from achalasia have difficulty swallowing food and liquids, as the lower esophageal sphincter – the gateway to the stomach – is unable to relax and open.
Treating Achalasia with Esophageal Myotomy
The esophageal myotomy is performed to provide relief to people who suffer from the symptoms of achalasia. Like the Nissen fundoplication procedure, the esophageal myotomy is performed as a laparoscopic surgery at our practice in La Jolla, close to both the North County and metro San Diego areas. Though it is a complicated procedure, our expert surgeons possess the knowledge, training, and skill necessary to perform the surgery safely and successfully.
The Procedure
During an esophageal myotomy, a vertical incision is made along the esophagus, typically from a position slightly above the LES down toward the stomach; the incision is made only through the outermost layers of the esophageal muscles. Following the laparoscopic esophageal myotomy, patients will be able to swallow food and fluids much more easily.
In some cases, the incision in the esophagus allows stomach acids to reflux. This condition often requires the surgeon to perform a simultaneous partial fundoplication to prevent any subsequent occurrence of gastroesophageal reflux disease.
Learn More about Laparoscopic Surgery near North County and San Diego
The physicians of Surgical Associates of La Jolla always perform minimally invasive, laparoscopic surgery when it is a safe option for their La Jolla, North County, and San Diego-area patients. To learn more about treating gastroesophageal reflux disease, achalasia, or a hiatal hernia with laparoscopic surgery, please contact our practice today to schedule a private, informative consultation.
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For more information about advance laparoscopic surgery options, contact Surgical Associates of La Jolla, serving the North County and metro San Diego areas.
La Jolla Weight Management
Dr. Sunil Bhoyrul
9850 Genesee Ave., Suite 730
La Jolla, CA 92037
Phone: (858) 457-4917
Fax: (858) 457-3287
Surgical Associates of La Jolla
Dr. Paul Hyde
Dr. Mark Sherman
Dr. Cheryl Olson
9850 Genesee Ave., Suite 660
La Jolla, CA 92037
Phone: (858) 452-5054
Fax: (858) 452-5097
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