Anti-Reflux Surgery (Laparoscopic Fundoplication and Hiatal Hernia Repair)

Anti-reflux surgery rebuilds the valve between the gullet and the stomach. Through keyhole incisions the surgeon returns any hiatal hernia to the abdomen, narrows the opening in the diaphragm and wraps the top of the stomach around the lower oesophagus (fundoplication).

It controls heartburn and regurgitation in roughly 85 to 90 percent of well selected patients and can end the need for daily acid tablets. It trades reflux for some new sensations, mainly bloating and difficulty belching, and a minority need medication again years later.

What Anti-Reflux Surgery (Laparoscopic Fundoplication and Hiatal Hernia Repair) involves

Work-up is essential: gastroscopy, oesophageal manometry to check the gullet's squeeze, and often 24-hour pH or impedance monitoring to prove that acid reflux causes your symptoms. At surgery, five small ports are placed in the upper abdomen. The stomach and lower oesophagus are freed from the chest so that at least 2 to 3 centimetres of oesophagus lies below the diaphragm without tension. The two pillars of the diaphragm are stitched together behind the oesophagus; mesh reinforcement is reserved for large hernias. The stomach fundus is then passed behind the oesophagus and sutured either fully around it (Nissen, 360 degrees) or partly (Toupet, 270 degrees), loosely, over a sizing tube.

Who is a good candidate for Anti-Reflux Surgery (Laparoscopic Fundoplication and Hiatal Hernia Repair)?

The operation suits proven reflux disease, not simply indigestion.

• Typical heartburn and regurgitation that respond to acid tablets but return when they are stopped
• Regurgitation, night-time choking or aspiration despite full medication
• Objective proof on pH testing or erosive oesophagitis at endoscopy
• Large or para-oesophageal hiatal hernia causing symptoms, anaemia or breathlessness
• Preference to avoid lifelong medication, after informed discussion

It is usually not the right choice if:

• Symptoms that never improved at all on acid suppression and normal pH studies
• Major oesophageal motility disorders such as achalasia
• Body mass index above about 35, where gastric bypass treats reflux better
• Mainly bloating, nausea or upper abdominal pain, which surgery may worsen
• Unfit for general anaesthesia

الخيارات التقنية

• Nissen fundoplication: Full wrap; strongest reflux control, more gas-related side effects.
• Toupet fundoplication: Partial posterior wrap; less trouble swallowing and belching, favoured when the oesophageal squeeze is weak.
• Hiatal hernia repair with or without mesh: Always combined with a wrap; mesh considered for very large defects.
• Magnetic sphincter augmentation (LINX): A ring of magnetic beads around the valve; an option for small hernias in some centres.
• Robotic assistance: Same operation with robotic instruments; no clear difference in outcome.

ماذا يحدث خلال علاجك

Surgery takes 1 to 2 hours, longer for giant hernias, under general anaesthesia. You stay 1 to 2 nights. Shoulder tip pain from the gas and a feeling of food sticking are usual in the first days. You start with liquids the same evening.

الإعداد لرحلتك

Plan for 7 to 10 days in Istanbul. Your surgeon reviews photographs and your medical history before you book, and you meet in person the day before surgery for examination, marking and consent with a professional interpreter.

• Stop smoking and nicotine at least four weeks before and after surgery; it is the single biggest avoidable cause of wound problems
• Tell the team about every medicine and supplement you take; blood thinners, some herbal products and hormone treatment may need to be paused on your doctor's advice
• Arrange for someone to travel with you or to be reachable, and keep the first days at home free of work and lifting
• Book a changeable return flight; your surgeon confirms when you are fit to fly

التعافي والنتائج

Swallowing is tight for 2 to 6 weeks while swelling settles. You follow a staged diet: liquids, then pureed, then soft food, avoiding bread, dry meat and fizzy drinks for about 6 weeks. Office work resumes at 1 to 2 weeks; avoid heavy lifting and straining for 6 weeks to protect the diaphragm repair. Expect to lose a few kilograms. Most people stop acid tablets immediately.

• Back to everyday activity: 1 to 2 weeks
• When results show: Reflux control immediate
• How long they last: Most have lasting control; about 1 in 10 to 1 in 5 resume tablets by 10 years

سياسة السلامة والمخاطر والتنقيح

Keyhole fundoplication is safe in experienced hands; the concerns are mostly functional.

• Persistent difficulty swallowing needing dilatation or, rarely, revision
• Gas bloat, increased flatulence and inability to belch or vomit
• Recurrence of reflux or of the hernia, more likely with very large hernias
• Wrap slipping or migrating into the chest
• Injury to the oesophagus, stomach, spleen or vagus nerve, uncommon
• Diarrhoea or early fullness, usually temporary

Every written proposal arranged through Clinic-Y states what the clinic covers if a correction is needed. Ask for it before you book, not after.

Cost of Anti-Reflux Surgery (Laparoscopic Fundoplication and Hiatal Hernia Repair) in Türkiye

Clinic-Y does not publish a single price for Anti-Reflux Surgery (Laparoscopic Fundoplication and Hiatal Hernia Repair), because the honest figure depends on your case. What moves it:

• Size of the hiatal hernia and operating time
• Mesh or robotic system use
• Pre-operative manometry and pH studies
• Nights in hospital
• Primary versus revision surgery

Send your photographs or reports and you receive written, all-inclusive proposals from suitable teams, side by side. Reviewing your case is free.

الأسئلة المتكررة