The most common of these operations is called a Nissen Fundoplication. It is commonly called a “wrap”, because the top portion of the stomach (the fundus) is wrapped (“plicated”) around the lower 2 inches of the esophagus to recreate the valve. If present, a hiatal hernia is repaired also. (A hiatal hernia occurs when the opening in the diaphragm that allows the esophagus to pass from the chest to the abdomen gets too large. Part of the stomach can then protrude (“herniate”) into the chest.) For the last 18 years, the Nissen operation has been done laparoscopically. This involves making 4-6 small (less than an inch) incisions and inserting a small camera and doing the surgery while watching a video monitor. Most patients are out of the hospital the same day or the next day after surgery. The laparoscopic approach represented a huge advance in the healing and recovery time compared to the “open” procedure (which was done through an incision from the ribs to the belly button). 85-90% of patients report good control of their reflux and the ability to reduce or eliminate their need for medications. However, 5-30 percent of patients will complain of bloating, difficulty swallowing, or diarrhea after the operation. The next advance in the correction of the faulty valve is the TIF procedure. This
stands for Transoral Incisionless Fundoplication. Though this a mouthful to say, the name says exactly what this procedure involves. It is a Fundoplication (recreating the valve) done via a Transoral (through the mouth, throat, and down the esophagus) thereby avoiding any incisions (Incisionless) on the abdomen. The procedure takes about 45 minutes to perform and patients spend the night in the hospital for IV fluids. Liquids can be started the next day. Since there are no incisions, there is very little pain after the procedure. Over the next 4-6 weeks patients can start to lift more, and advance from liquids to soft to regular foods. Dr John Koziarski, at Bronson Battle Creek, is the first in the Battle Creek/Kalamazoo area to do the TIF procedure. In the last 18 years he has performed hundreds of operations for patients with reflux as well as hiatal hernias. Adding the TIF procedure to his armamentarium of treating GERD represents Dr Koziarski’s commitment to staying on the leading edge of medical advancements. If you would like more information about treating your GERD symptoms, or want to see if you could do something to eliminate having to take antacid medications the rest of your life, call Dr Koziarski at Family Surgical, PLC, 269-979-6200, www.famsurg.com.
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Memory Care Residence
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Senior Connection | March 25, 2012
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