The prestigious General Surgeon and expert in laparoscopic surgery for gastroesophageal reflux explains this technique and the causes of heartburn.
What is gastroesophageal reflux and what causes it?
Gastroesophageal reflux disease is a relatively uncommon pathology that we observe in approximately 7 to 10% of the population. Its importance is highly variable. Some patients present heartburn after large meals but in other cases a burning sensation of the esophagus appears and that in the long run in a chronic reflux situation can lead to the appearance of a burn of the esophagus that we call reflux esophagitis.
What causes it?
In a normal situation, there is a series of anchorage and anatomical mechanisms at the hiatal region and a sphincteric mechanism that prevents gastroesophageal reflux. There are two situations in which this can appear. First, when the sphincteric mechanism that exists at the esophagogastric junction fails, we see that the acid content of the stomach has a tendency to ascend upwards causing reflux. The other situation in which reflux can occur is when there is a hiatal hernia. In these cases, the esophageal hiatus has lost its anatomical anchors and the acid content of the stomach also rises causing reflux and, consequently, esophagitis.
What are the objectives of this surgery?
The objectives of gastroesophageal reflux surgery are basically twofold. First of all, it is a matter of replacing the hiatal region in its anatomical situation, but we also have to establish a mechanism so that the acid reflux from the stomach cannot ascend towards the esophagus.
What does the intervention consist of?
The procedure to treat gastroesophageal reflux consists of a Nissen fundoplication, which is obviously performed laparoscopically. What we do in this intervention is to close the pillars of the diaphragm and on the other hand to use the fundus of the stomach to establish a mechanism that prevents the stomach acid from rising and continuing to maintain the burn.
Is it a definitive solution?
The anti-reflux procedure is a definitive solution in a very high percentage of cases. We estimate that the percentage of excellent results is around 95% and that the percentage of complications is extremely low, especially with the use of laparoscopy.