Acid Reflux Surgery: Open vs. Laparoscopic
Acid Reflux disease is the most common upper gastrointestinal disease in the United States. While diet, lifestyle changes, and losing weight often can improve symptoms, it doesn’t always work for everyone.
Many people find these changes difficult, which leads them to use medications (typically proton pump inhibitors or H2 blockers) to treat their reflux pain. Increasingly, the literature and research on acid reflux disease indicates more and more risk associated with taking the medications frequently used to treat the condition, especially high dose or long term use. Newer studies showing that anti-reflux surgeries may also work to control acid reflux symptoms — and without the side effects from taking medications — make many people consider surgery. Patients who benefit most from acid reflux surgeries are those who have responded to the acid reflux medications first.
Acid reflux surgeries can either be handled in the traditional, “open” procedure, or done laparoscopically.
The open fundoplication surgery is the most common and involves a six-inch vertical incision from sternum to navel. The surgeon then wraps a portion of the stomach around the lower esophagus to create a one-way valve and tighten the sphincter. An open surgery can require up to a week in the hospital, as well as an additional six weeks before one is able to return to work, often making the cost significantly higher.
The laparoscopic fundoplication surgery involves five 10-millimeter incisions for the laparoscopic tools to inflate the abdominal cavity with carbon dioxide, which lifts the abdominal wall from the organs. Once inflated, the surgeon can correct the lower esophageal sphincter. People recover more quickly from this procedure, staying an average of one to two days in the hospital, which lowers the overall cost. There is also less pain, scarring, and risk of complications with the laparoscopic procedure.
Though laparoscopy may seem like the obvious choice, it’s not always the best option for people with excessive scar tissue from previous surgeries, widespread abdominal disease, or infection of the area.
While only your physician can determine which procedure is right for you, it is important to know your options. Because of technological advancements in the field of anti-reflux surgery, there are also various procedures within each category that are not surgical but still mechanically improve the acid reflux. Be sure to do your research and ask questions. In the end, it is your health, in both the long and short term, that matters most.
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