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A Nissen fundoplication is an operation that aims to prevent acid reflux, which is where acid from your stomach travels up into your oesophagus (gullet). The procedure involves wrapping the top part of your stomach around your oesophagus, which makes it harder for acid to travel back up into your gullet.
A laparoscopic Nissen fundoplication, or lap Nissen, is when the procedure is done using minimally invasive (keyhole) surgery techniques.
If you are living with gastro-oesophageal reflux disease (GORD) that has not responded to medication, then a Nissen fundoplication could be an option for you. If your reflux is related to a hiatus hernia, this can be treated during the same procedure.
To find out more, call or book online to arrange a consultation with one of our specialists. We have a network of talented surgeons across our 50+ UK private hospitals that can help you to find the right solution for your chronic reflux.
What is acid reflux?
It is normal for a small amount of acid to travel up from your stomach and into your oesophagus. However, if this happens too often it can cause symptoms of a burning sensation in your chest (often known as heartburn) or acid in the back of your mouth.
Too much acid travelling up into your gullet is known as acid reflux, and when this becomes a recurring problem it is known as chronic reflux or gastro-oesophageal reflux disease (GORD). Over time, the acid can cause the lining of your oesophagus to become inflamed (oesophagitis) or scarred.
Many people find that medications for GORD are very effective and can successfully manage their symptoms. However, if your symptoms continue even when you're taking medication, your consultant might recommend surgery.
The main benefit of having this type of surgery for GORD is that you should get relief from symptoms of acid reflux without needing to take medication.
Are there any alternatives to a Nissen fundoplication?
Medication that lowers the acid content in your stomach is effective at controlling symptoms and healing the inflammation in your oesophagus.
Surgery is recommended only if the symptoms continue while you are taking the medication, or if you feel that you would prefer to have an operation than take medication for the rest of your life.
There are other surgical options to treat GORD and your consultant surgeon will take you through these if they are suitable for you. They include a partial fundoplication, and a magnetic band that is implanted to strengthen your lower oesophageal sphincter.
The operation is performed under a general anaesthetic and usually takes 1 to 2 hours. Your surgeon will use laparoscopic surgery (keyhole surgery) as this is associated with less pain, less scarring and a faster return to normal activities compared with open surgery.
They will make several small incisions (cuts) into your abdomen so that they can insert tubes (ports) into your abdomen. Your surgeon will insert surgical instruments through the ports, along with a device called a laparoscope that allows them to see inside your abdomen and perform the operation. They will stitch your diaphragm to reduce the size of the hole your oesophagus passes through. Your surgeon will wrap and stitch the top part of your stomach around your lower oesophagus, to produce a valve effect.
If you have a hiatal hernia, your surgeon should be able to repair the hernia during the same operation, using permanent stitches to keep the herniated area of your stomach in place.
How soon will I recover?
You should be able to go home the next day.
Most people are able to return to work after 3 to 4 weeks, though this will depend on the exact details of your surgery as well as what type of work you do.
Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, ask the healthcare team or your GP for advice.
After laparoscopic Nissen fundoplication, we expect you to make a full recovery, with the symptoms of acid reflux gone or at least much improved.
Like all surgical procedures, there are potential complications of Nissen fundoplication, but the risks are low. Your consultant surgeon will explain all of these to you ahead of time so that you can allay your worries and make an informed decision.
General complications that can arise after any operation include:
- Pain
- Bleeding
- Scars
- Infection of the surgical site (wound)
- Blood clots
Specific complications that could happen after a lap Nissen include:
- Damage to surrounding tissues or structures
- Hernia
- Pneumothorax, where air escapes into the space around your lung
- Difficulty swallowing for a few months or longer
- Incomplete control of reflux symptoms
- Weight loss
The cost of laparoscopic Nissen fundoplication depends on which hospital you have surgery in and who you have surgery with.
Our fixed-price packages include the cost of your surgery and all appropriate aftercare appointments. However, any pre-surgery diagnostic tests and your consultant's outpatient appointment consultation fee are charged separately.
Our flexible payment options help you spread the cost of your payment across a time period that suits you. We offer fixed-term monthly payment plans over one to five years with no deposit required. If you decide to pay over 10 months, you will pay interest-free. If you are paying for a longer period, you will pay 14.9% APR.
If you have private health insurance, GORD surgery may be covered by your provider. Speak to your insurer directly to find out.
At Circle Health Group we have the experience and expertise to ensure the best possible care and outcome for our patients. As a patient with Circle Health Group, you can expect the highest standards of care including:
- Flexible appointment times and locations that are convenient for you
- The freedom to choose which hospital and consultant suit your needs
- Personalised, consultant-led treatment plans tailored to your individual needs
- Comfortable and safe private facilities maintained by expert multidisciplinary teams
- Private ensuite rooms as standard
- A range of delicious healthy meals
- Affordable, fixed-price packages with aftercare included
- Flexible payment options to help you spread the cost of your care
If you would like to see a consultant or learn more about treatments for chronic reflux, book your appointment online today or call a member of our team directly.
Content reviewed by Circle in-house team in March 2023. Next review due March 2026.
- GERD surgery, Mayo Clinic
- Nissen fundoplication, Cleveland Clinic
- Nissen fundoplication for severe acid reflux, NHS
