Anti-reflux (Nissen’s) Fundoplication 

A surgical solution for severe acid reflux

Anti-reflux (Nissen’s) fundoplication is a surgical procedure that aims to treat severe acid reflux, a condition where stomach acid frequently flows back into the oesophagus, causing discomfort and symptoms like heartburn and regurgitation.

During the surgery, the upper part of the stomach is wrapped around the lower end of the oesophagus (the tube that carries food from your mouth to your stomach). This wrapping creates a barrier that prevents stomach acid from flowing back up into the oesophagus, helping to reduce those uncomfortable symptoms.

The surgery is often done using a laparoscopic technique, which means the surgeon makes small cuts instead of a large incision in your abdomen. This minimally invasive approach usually leads to quicker recovery times and less pain compared to traditional open surgery, where a larger cut is made.

For individuals struggling with the discomfort of severe acid reflux, anti-reflux (Nissen’s) fundoplication can provide significant relief and improve overall quality of life.

Who is a Candidate?

Patients with severe or chronic gastroesophageal reflux disease (GORD) that does not respond to medical therapy.

Common indications include:

• Persistent acid reflux despite proton pump inhibitor (PPI) medication
• Hiatal hernia associated with reflux
• Regurgitation, aspiration, or chronic cough from reflux
• Barrett’s oesophagus with ongoing symptoms
• Reflux-related asthma or laryngitis.

Recovery Timeline

This is likely to vary with provider.

• Hospital stay: Typically 1–3 days
• Initial recovery:
  • Liquid diet for the first few days → gradual progression to soft foods
  • Temporary difficulty swallowing may occur for 1–2 weeks
• Return to light activities: Within 2–3 weeks (laparoscopic), 4–6 weeks (open).
• Full recovery: Usually by 6 weeks.

Most patients experience immediate relief from reflux symptoms after surgery.

Benefits

• Prevents acid reflux by reinforcing the lower oesophageal sphincter

• Reduces or eliminates heartburn, regurgitation, and PPI dependence

• Improves quality of life and protects oesophagus from chronic acid damage

• Can repair associated hiatus hernia simultaneously.

Risks

• Dysphagia (trouble swallowing) due to tight wrap — usually temporary
• Gas-bloat syndrome — difficulty belching or vomiting → bloating and discomfort
• Slippage or loosening of the wrap → recurrence of reflux
• Infection, bleeding, or anaesthetic risks (as with any surgery).

Nissen’s fundoplication is a type of laparoscopic anti-reflux surgery that wraps the stomach’s upper part (fundus) around the oesophagus to strengthen the lower sphincter - offering excellent long-term relief from GORD but may cause bloating and swallowing difficulties if too tight.

This is just an outline. Your specialist surgeon will be able to talk to you about these issues in more detail and make sure that there is informed consent.