Nissen Fundoplication: The Gold Standard for GERD Relief

The Laparoscopic Nissen Fundoplication is a proven surgical procedure designed to treat severe Gastroesophageal Reflux Disease (GERD) and repair hiatal hernias. While many patients find relief through medication or the incisionless TIF procedure, the Nissen Fundoplication remains the definitive “Gold Standard” for long-term control of acid reflux, especially in complex cases.

At Advanced Bariatric & Surgical Specialists, Dr. Craig Chang performs this procedure using minimally invasive laparoscopic techniques, providing a permanent mechanical solution to a chronic problem.

What is Nissen Fundoplication?

The goal of the procedure is to reinforce the Lower Esophageal Sphincter (LES)—the muscular valve at the bottom of the esophagus that is supposed to prevent stomach acid from backing up.

The Procedure

Using 4-5 tiny abdominal incisions, Dr. Chang:

1. Repairs any Hiatal Hernia: If the stomach has slipped into the chest cavity, it is gently pulled back into the abdomen.
2. Wraps the Stomach: The upper part of the stomach (the fundus) is wrapped 360 degrees around the lower esophagus.
3. Secures the Valve: The wrap is sutured in place, creating a one-way valve that allows food to enter the stomach but prevents acid from splashing back up.

Who is a Candidate?

Nissen Fundoplication is often the best choice for patients who:

• Have severe GERD that does not respond to medication (PPIs).
• Have a large hiatal hernia that must be repaired.
• Experience atypical symptoms like chronic cough, asthma, or hoarseness caused by reflux.
• Have developed Barrett’s Esophagus or severe esophagitis.
• Prefer a one-time permanent surgical fix over a lifetime of daily medication.

It is worth knowing that patients with a paraesophageal hiatal hernia, one that has lodged itself adjacent to the esophagus, must be treated using Nissen or full-wrap fundoplication versus partial wrap fundoplications that are often used for sliding hiatal hernias.

The Laparoscopic Advantage

By performing the Nissen Fundoplication laparoscopically, Dr. Chang offers patients a significantly easier recovery than traditional “open” surgery.

• Hospital Stay: Usually just one night for observation.
• Minimal Scarring: Tiny incisions result in less cosmetic impact and lower risk of infection.
• Precision: The laparoscopic camera provides a magnified view of the esophagus and diaphragm, allowing for meticulous surgical repair.

Recovery and Results

Dietary Transition: Because the new valve is initially swollen, patients follow a specific Fundoplication Diet (liquid and soft foods) for a few weeks. This allows the esophagus to heal and ensures the “wrap” stays securely in place.

Long-Term Success: The majority of patients experience an immediate and dramatic disappearance of heartburn and regurgitation. Most are able to discontinue all anti-reflux medications shortly after surgery.

Why Choose Dr. Chang?

Success in fundoplication depends heavily on the surgeon’s experience—the wrap must be “just right” (not too tight and not too loose). Dr. Craig Chang is highly experienced in the delicate anatomy of the esophagus and diaphragm. He takes the time to evaluate your specific anatomy through diagnostic testing to ensure the Nissen Fundoplication is the right choice.

Ready for a Permanent Solution?

If you are tired of living on antacids and dealing with the pain of chronic reflux, it’s time to explore a permanent fix. Contact our Victoria or Corpus Christi office today.