Anti Reflux Procedures | General Surgeon, Dr. Joshua Taylor in Symrna, TN

Surgical treatment options

The traditional that way reflux has been treated with surgery has been something called a fundoplication.

The most common fundoplication is something called a Nissen or a 360 degree fundoplication. So, they way that I describe it to patients is that essentially we're creating a speed bump around your esophagus by taking the top part of the stomach and wrapping it kind of snuggly around the esophagus so that acid can't reflux up. There are variations on that. So, there may not be a complete wrap, something called a 270 degree or a toupet wrap. And, those decisions are made on how well you swallow and other things from that standpoint.

Those are the traditional options. They can be done both open or minimally invasive, whether that be laparoscopic or robotic. Again, the Nissen fundoplication is really kind of considered the tried-and-true surgical procedure.

Newer procedures now, one of which is the TIF (transoral incisionless fundoplication). That's where through the scope procedure, we take and re-create that natural reflux valve barrier that should exist between the swallowing tube and the stomach, and essentially create a fundoplication but internal. What that does is it allows for things to travel through the esophagus into the stomach in a more functional way. So it's not that sort of wrap where things are heavy and can potentially not only stop things from coming up but stop things from going down as easily. But, because you're recreating that valve (its sort of a one-way valve) so things will go down more easily but not allow acid to reflux up as well.