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Anti-reflux surgery - children - Overview

Alternative Names

Fundoplication - children; Nissen fundoplication - children; Belsey (Mark IV) fundoplication - children; Toupet fundoplication - children; Thal fundoplication - children; Hiatal hernia repair - children; Endoluminal fundoplication - children

Definition of Anti-reflux surgery - children:

Anti-reflux surgery is surgery to repair 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 repair a hiatal hernia.

Description:

A procedure called fundoplication is the most common type of anti-reflux surgery. Your child will be under general anesthesia during surgery. This will make your child unconscious and unable to feel pain. This surgery usually takes 2 to 3 hours.

  • During this surgery, the surgeon will use stitches to wrap the upper part of your childā ' s stomach around the end of the esophagus. This helps prevent stomach acid and food from flowing back up.
  • A g-tube (gastrostomy tube) may be placed to help with feeding and to release air from your childā ' s stomach. The surgeon may use a g-tube if your child has had swallowing or feeding problems.
  • The surgeon may do another procedure called a pyloroplasty. This procedure widens the opening between the stomach and small intestine so that the stomach can empty faster.

Ways the doctor may do this surgery are:

  • Open repair. The surgeon will make a large incision (cut) in your childā ' s belly area (abdomen).
  • Laparoscopic repair. The surgeon will make 3 to 5 small incisions in the belly. The surgeon will insert a laparoscope (a thin, hollow tube with a tiny camera on the end) through one of these incisions and other tools through the other incisions. 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.

  • Reviewed last on: 3/6/2009
  • George F Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Brant K. Oelschlager BK, Eubanks TR, Pellegrini CA. Hiatal Hernia and Gastroesophageal Reflux Disease. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 42.

Orenstein S, Peters J, Khan S, Youssef N, Hussain SZ. Gastroesophageal reflux disease (GERD). In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 320.

Lobe TE. The current role of laparoscopic surgery for gastroesophageal reflux disease in infants and children. Surg Endosc. 2007 Feb;21(2):167-74.

Saedon M, Gourgiotis S, Germanos S. Is there a changing trend in surgical management of gastroesophageal reflux disease in children? World J Gastroenterol. 2007 Sep 7;13(33):4417-22.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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