About the Director

The problem of heartburn is universal. However, the problem of reflux disease is serious. It is now believed that medications only serve to control the discomfort of reflux, but may, in fact, do the patient a disservice if he or she has true reflux disease, because complications from the disease may be promoted and postponed until severe disease occurs. For this reason, it is highly recommended now that all patients with significant symptoms of gastroesophageal reflux disease be fully evaluated and treated appropriately.

Traditional Surgery For Gastroesophageal Reflux Disease

With modern technology and advanced research, gastroesophageal reflux disease has now been recognized to result from a defect in the anatomy of the gastroesophageal junction and the lower esophagus. It is now recognized that this is a mechanical problem which requires a mechanical solution with surgery.

In 1955, Dr. Frederick Nissen developed an operation which repaired the hiatal hernia and also brought the lower esophagus back into the abdominal cavity. In this operation, the top of the stomach is wrapped around the lower esophagus in order to create a greater length in the lower esophagus and a smaller diameter. This follows a law of physics called the law of Laplace, which states that a smaller tube is more difficult to distend than a larger tube.

In the past forty years, the Nissen fundoplication has withstood the test of time, and is now recognized as the operation of choice for this disease. Many researchers report cure rates of 90% or greater over a ten - to twenty-year period for this procedure.

Laparoscopic Anti-Reflux Surgery

In recent years, minimally invasive surgery performed through tiny incisions in the abdominal cavity has developed. A small telescope connected with a camera and video monitor is used to visualize the operation. Removing the gallbladder with this method has become the surgery of choice for gallbladder disease because the patient's pain and suffering following the surgery has been significantly reduced. In 1991, Dr. Bernard Dallemagne of Liege, Belgium, performed the first laparoscopically guided Nissen fundoplication. Since then, thousands of patients have been treated in this manner in Europe and America. Reports are that the success of the new method may be even greater than with the original open surgical procedure. Many centers around the world are now duplicating Dr. Dallemagne's achievements and are performing the operation successfully.

In most cases, the operation takes approximately 1 1/2 hours to perform. It entails five tiny incisions which require only Band Aids after the operation. Little discomfort is usually experienced and, in most cases, the patient is released from the hospital in 24 hours.

It should be remembered that this is not a new operation. This is the same operation described by Dr. Nissen and tested by time and experience over the years. Only the technique of performing the operation laparoscopically is new. By using the laparoscopic method, the precision in which the operation can be performed enables the surgeon to perform microscopic surgery on the area of disease. Many surgeons recognize that the laparoscopic method is a major improvement on the open surgical procedure.