What Is Endoscopic Fundoplication?

Endoscopic fundoplication is a relatively noninvasive surgical procedure used to alleviate symptoms of gastroesophageal reflux disease (GERD). Contrary to traditional fundoplication surgery, endoscopic fundoplication offers a simpler alternative to traditional surgery with reduced healing time and risk for complication. Endoscopic fundoplication still carries some risks, and these should be discussed during one's consultation prior to surgery.

The family of anti-reflux procedures is known commonly as Nissen fundoplication. When traditional treatments have little to no effect on symptoms, individuals may opt for surgery to alleviate their discomfort. Instead of undergoing an open surgery, which involves opening the chest or abdominal cavity, individuals may undergo endoscopic fundoplication.

Prior to the surgery, a small, thin tube, called an endoscope, is introduced into the patient’s throat. As the patient swallows the tube, it journeys down the esophagus, settling in the area of the esophageal sphincter. Tiny instrumentation is funneled through the endoscope to the surgical site. Outfitted with a camera, the endoscope allows the attending surgeon a comprehensive view of the targeted area.

Once the endoscope is in position, several methods may be used to amend the sphincter and reduce acid backflow. Pleats may be taken in the surrounding stomach tissue and sutured to tighten the sphincter. The reattached tissue contracts the folds of the sphincter to increase pressure and limit acid backflow.

Another treatment method involves the application of an electrical current to the targeted esophageal tissue intended to scar and make it taut. Known as the Stretta procedure, the electrical currents effectively deaden nerve endings that play a pivotal role in reflux. In some instances, supplemental material may be introduced to bulk up the sphincter and narrow its passage to limit acid reflux.

During the consultation process, the patient is educated about pre- and post-operative measures he or she must take. All medications that may impair the surgery's success may be temporarily discontinued prior to surgery. It is not uncommon for people who undergo endoscopic fundoplication to experience post-operative throat discomfort. Since endoscopic fundoplication is performed on an inpatient basis, individuals should expect to stay in the hospital for a few days.

In most cases, patients who undergo endoscopic fundoplication are instructed to make post-operative dietary changes that promote healing once they are able to resume eating solid foods. For instance, patients are discouraged from consuming irritating beverages, like soda, and foods that may overwhelm or harm the healing tissues, such as spicy dishes. Depending on surgery success, individuals may permanently discontinue the use of their GERD medications. Risks associated with endoscopic fundoplication can include recurrent reflux, nerve damage, and infection.