Definition of Anti-reflux surgery - children:

Anti-reflux surgery is surgery to tighten the muscles at the bottom of the esophagus (the tube that carries food from the mouth to the stomach). Problems with these muscles can lead to gastroesophageal reflux disease (GERD).

This surgery can also be done during a hiatal hernia repair.

This article discusses anti-reflux surgery repair in children.

Description:

The most common type of anti-reflux surgery is called fundoplication. This surgery usually takes 2 to 3 hours.

Your child will be give general anesthesia before the surgery. That means the child will be asleep and unable to feel pain during the procedure.

The surgeon will use stitches to wrap the upper part of your child' s stomach around the end of the esophagus. This helps prevent stomach acid and food from flowing back up.

A gastrostomy tube (g-tube) may be put in place if your child has had swallowing or feeding problems. This tube helps with feeding and releases air from your child' s stomach.

Another surgery, called pyloroplasty may also be done. This surgery widens the opening between the stomach and small intestine so the stomach can empty faster.

This surgery may be done several ways, including:

• Open repair: The surgeon will make a large cut in the child' s belly area (abdomen).
• Laparoscopic repair: The surgeon will make 3 to 5 small cuts in the belly. A thin, hollow tube with a tiny camera on the end (a laparoscope) is placed through one of these cuts. Other tools are passed through the other surgical cuts.

The surgeon may need to switch to an open procedure if there is bleeding, a lot of scar tissue from earlier surgeries, or if the child is very overweight.

Endoluminal fundoplication is similar to a laparoscopic repair, but the surgeon reaches the stomach by going through the mouth. Small clips are used to tighten the connection between the stomach and esophagus.

Why the Procedure Is Performed:

Anti-reflux surgery is usually done to treat GERD in children only after medicines have not worked or complications develop. Your child' s doctor may suggest anti-reflux surgery when:

• Your child has symptoms of heartburn that get better with medicines, but you do not want your child to continue taking these medicines. Symptoms of heartburn are burning in their stomach, throat, or chest, burping or gas bubbles, or problems swallowing food or fluids.
• Part of your child' s stomach is getting stuck in the chest or is twisting around itself.
• Your child has a narrowing of the esophagus (called stricture) or bleeding in the esophagus
• Your child is not growing well or is failing to thrive.
• Your child has a lung infection caused by breathing contents of the stomach into the lungs (called aspiration pneumonia)
• Gerd causes a chronic cough or hoarseness in your child.