Nissen Fundoplication – Surgery for Acid Reflux (GERD)
If heartburn medicines are no longer working, or you cannot tolerate daily proton-pump inhibitors (PPIs), laparoscopic Nissen fundoplication can stop reflux at its source. This guide from the surgical gastroenterology team at Dhaara Speciality Hospital, Yelahanka, explains who benefits, what the tests show, and what recovery looks like.
Dhaara Speciality Hospital, Yelahanka
61 Jakkur Road, Yelahanka, Bengaluru 560064
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Key Takeaways
- Nissen fundoplication wraps the top of the stomach around the lower oesophagus to rebuild the anti-reflux barrier.
- It is keyhole (laparoscopic) surgery performed under general anaesthesia, usually with 1–2 days in hospital.
- Best suited to patients with proven reflux (endoscopy or pH testing) who have incomplete relief on medicines or cannot take medicines long term.
- Written for patients in Yelahanka and North Bangalore — always confirm your specific case with a surgeon.
Chronic acid reflux (GERD) is one of the most common reasons people in North Bangalore visit a gastroenterologist. For most patients, lifestyle changes and medicines control GERD well. But if symptoms return despite treatment, doses keep rising, or daily PPIs cause side effects, laparoscopic Nissen fundoplication offers a durable fix — without lifelong tablets.
At Dhaara Speciality Hospital, Yelahanka, the surgical gastroenterology team led by Dr. Srinivas Bojanapu performs fundoplication as keyhole surgery through four to five small cuts, most patients going home within 24–48 hours.
What Is Nissen Fundoplication?
In reflux, the valve at the bottom of the food pipe (lower oesophageal sphincter) is weak — often because some of the stomach has slipped into the chest through the diaphragm (a hiatal hernia). During a Nissen fundoplication the surgeon:.
- Pulls the stomach fully back into the abdomen.
- Closes the enlarged diaphragm opening (hiatal hernia repair).
- Wraps the upper stomach 360° around the lower oesophagus — rebuilding the valve.
Because everything is done with a camera and long instruments, there is no large cut. Partial wraps (Toupet) may be chosen when swallowing difficulties or motility issues are present.
Who Needs Surgery?
Good Candidates
- Reflux confirmed on endoscopy, pH-manometry or barium studies
- Symptoms incompletely controlled by PPIs, or relapse when trying to stop them
- Chest pain/night cough/asthma-like symptoms linked to reflux
- Hiatal hernia with reflux
Discuss Alternatives When
- Severe weak oesophageal contractions
- Large stomach contained entirely in the chest (giant sliding/para-oesophageal hernia)
- Reflux symptoms without objective confirmation on testing
Tests Before Surgery
- Upper GI endoscopy — painless day-care endoscopy at Dhaara checks oesophagitis, hiatal hernia size and pre-cancerous changes (Barrett’s).
- 24-hour pH study — confirms that symptoms relate to acid reflux (essential when endoscopy is normal).
- Manometry — measures how the oesophagus squeezes, guiding full vs partial wrap.
- Blood groups, fitness tests and anaesthetic review before the operation date.
Recovery Week by Week
Days 1–2
Clear fluids first, then soft foods. Most patients walk from day one; discharge within 24–48 hours.
Weeks 1–4
Soft/semi-solid diet while swelling settles. Avoid fizzy drinks, big meals and late dinners. Desk work is usually fine after 1–2 weeks.
Weeks 4–8
Normal diet resumes step by step. Heavy lifting avoided for 4–6 weeks; gym and travel follow the surgeon’s review.
Early swallowing difficulty or a sense of gas bloat is common and improves with time — the team reviews you before clearing normal diet.
Risks — Being Straight With You
Fundoplication is very successful for correctly selected patients, and complications are uncommon, but you should know them:
Common, Usually Temporary
- Difficulty swallowing (usually first 2–4 weeks)
- Gas bloat — inability to burp easily
- Feeling full after small meals
Uncommon, Needing Attention
- Wrap that is too tight or too loose (dysphagia or recurrent reflux)
- Hiatal hernia recurrence
- Bleeding, leak or injury to nearby organs (rare)
- Keyhole operation converted to open in difficult adhesions
10–20% of patients need some medicine again after many years — but compared with the pre-operative years, dependence on medicines drops sharply after a successful operation.
Life After Fundoplication
After recovery, most patients eat normally, sleep without reflux, and stop or reduce PPIs. Weight control, smaller dinners and not lying down straight after meals still help protect the repair. Smoking relapse risk goes up significantly — quitting protects your new valve.
Frequently Asked Questions
Questions About Your Surgery?
Talk to the surgical gastroenterology team at Dhaara Speciality Hospital, Yelahanka. Same-day appointments available.
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