What is Involved in Esophageal Sphincter Surgery?

Carol Kindle

Esophageal sphincter surgery is a procedure that serves to tighten the muscle between the esophagus and the stomach. Tightening the sphincter muscle, known as the lower esophageal sphincter, may relieve symptoms of gastroesophageal reflux disease (GERD). Reflux disease occurs when the sphincter muscle loosens and allows stomach acid to flow backward, up into the esophagus. Stomach acid can irritate the lining of the esophagus and cause pain and discomfort. Surgery to tighten the sphincter muscle can prevent stomach acid from going back up into the esophagus.

Esophageal sphincter surgery may reduce the symptoms and discomfort associated with GERD.
Esophageal sphincter surgery may reduce the symptoms and discomfort associated with GERD.

GERD is a severe form of indigestion that can lead to erosion of the esophagus. Symptoms of GERD include pain and burning in the area beneath the breastbone. Patients experiencing symptoms of GERD may try lifestyle and dietary changes, including eliminating caffeine and alcohol from the diet, as well as avoiding cigarettes and other nicotine products, to alleviate pain and discomfort. Caffeine, alcohol, and nicotine can all cause the esophageal sphincter to relax and not function properly. Eating small meals and never going to bed on a full stomach may also help alleviate symptoms of GERD.

Laparoscopic surgery is less invasive, allowing for a quicker recovery with less chance of complications.
Laparoscopic surgery is less invasive, allowing for a quicker recovery with less chance of complications.

Medications, such as antacids to neutralize stomach acid, or histamine blockers which reduce acid secretion, are usually prescribed for patients with GERD. Other medications, known as proton pump inhibitors, are prescribed to block acid production. In some patients, these medications are either ineffective or intolerable in the long-term. Esophageal sphincter surgery may be an option for these patients.

Eating small meals and never going to bed on a full stomach may help alleviate symptoms of GERD.
Eating small meals and never going to bed on a full stomach may help alleviate symptoms of GERD.

Esophageal sphincter surgery can be performed as an open or a laparoscopic surgery. The open surgery requires the surgeon to make a large incision in the abdomen. Laparoscopic surgery involves the use of a small camera and surgical instruments inserted into the abdomen through several smaller incisions in the abdomen. The laparoscopic procedure is more common and allows the patient to leave the hospital sooner and experience a faster recovery.

Esophageal sphincter surgery may help relieve symptoms of GERD.
Esophageal sphincter surgery may help relieve symptoms of GERD.

To perform the laparoscopic esophageal sphincter surgery, also known as fundoplication, the surgeon will first place the patient under general anesthesia. The surgeon will then make several small incisions in the abdomen. A camera and surgical instruments will be inserted into the abdomen. The surgeon will take the upper curved portion of the stomach, called the fundus, and curl it around the esophageal sphincter muscle and suture it in place. This reinforces the sphincter and restores its function in holding back stomach acid.

Laparoscopic surgery for an esophageal sphincter uses a small camera and surgical instruments inserted into the abdomen through several small incisions.
Laparoscopic surgery for an esophageal sphincter uses a small camera and surgical instruments inserted into the abdomen through several small incisions.

Patients should expect to spend one or two nights in the hospital and may need to eat only soft foods for several days after the surgery. Side effects from esophageal sphincter surgery include difficulty in swallowing and bloating after a meal. Some patients may experience a return of mild GERD symptoms over time.

During esophageal sphincter surgery, the surgeon will take the upper portion of the stomach, called the fundus, and curl it around the esophageal sphincter muscle and suture it in place.
During esophageal sphincter surgery, the surgeon will take the upper portion of the stomach, called the fundus, and curl it around the esophageal sphincter muscle and suture it in place.
Patients suffering from serious cases of GERD may require a feeding tube.
Patients suffering from serious cases of GERD may require a feeding tube.
A patient will be placed under general anesthesia prior to esophageal sphincter surgery.
A patient will be placed under general anesthesia prior to esophageal sphincter surgery.
Those with GERD are advised to avoid smoking.
Those with GERD are advised to avoid smoking.

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