Thoracic surgery focuses on diseases of the thorax (chest), including lung disease and other conditions.
Muscular tube that connects the mouth to the stomach.
The part of the stomach that is closest to the entry of the esophagus.
In patients with GERD, the lower esophageal sphincter (LES) is too weak to effectively hold food and fluids in the stomach — this allows stomach acid to escape into the esophagus, which irritates the esophagus which is often referred to as heartburn. Chronic heartburn can ultimately lead to chronic inflammatory changes, and then to ulcers and strictures (narrowing) of the esophagus. In some cases, it can also eventually lead to cancer of the esophagus.
A ring-shaped band of muscles at the junction of the stomach and esophagus.
Any of the small, bean-shaped organs located throughout the lymphatic system. The lymph nodes contain the immune system cells lymphocytes, which can trap cancer cells or bacteria that are traveling through the body.
The pleating and stitching of the walls of a body organ to reduce its size.
Caused when the stomach squeezes through the hiatus, an opening in the diaphragm through which the esophagus passes from the chest into the abdomen. When this opening becomes weakened or enlarged, a portion of the stomach and/or esophagus can bulge into the chest cavity.
Fundoplication is a standard surgical treatment for gastroesophageal reflux disease (GERD). Fundoplication gets its name from the fundus (upper portion of the stomach) and plication, a term for reducing the size of a hollow organ (stomach) by gathering or suturing.
During fundoplication, the fundus of the stomach is gathered, wrapped and sutured around the lower end of the esophagus and lower esophageal sphincter (LES). This increases the pressure at the lower end of the esophagus and reduces the acid reflux. There are two different types of wraps that may be used — the full wrap goes all the way around the lower esophagus while the partial wrap does not.
Regardless of which type of wrap is selected, the surgeon permanently stitches it in place. The wrap creates extra support to prevent reflux by increasing the LES pressure. Fundoplication may be done traditionally (using a large incision) or laparoscopically, requiring only several small incisions in the abdomen. Your surgeon will determine which option is best for you.
About 80% of patients with GERD have a hiatal hernia that requires treatment as well. If that is the case, during fundoplication, the hernial sac may be pulled down from the chest and sutured so that it remains within the abdomen. The opening in the diaphragm where the esophagus passes from the chest into the abdomen may also be tightened.