Healthdirect Free Australian health advice you can count on.

Medical problem? Call 1800 022 222. If you need urgent medical help, call triple zero immediately

healthdirect Australia is a free service where you can talk to a nurse or doctor who can help you know what to do.

beginning of content

Laparoscopic Nissen fundoplication

4-minute read

This page will give you information about a laparoscopic Nissen fundoplication. If you have any questions, you should ask your GP or other relevant health professional.

What is a Nissen fundoplication?

A Nissen fundoplication is an operation to prevent acid reflux, where acid from your stomach travels up into your oesophagus (gullet). It involves wrapping the top part of your stomach around your oesophagus.

It is normal for a small amount of acid to travel into your oesophagus. If this happens too often it can cause symptoms of a burning sensation in your chest (‘heartburn’) or acid in the back of your mouth. The acid can cause the lining of your oesophagus to become inflamed (oesophagitis) or scarred.

What are the benefits of surgery?

You should get relief from symptoms of acid reflux without needing to take medication.

Illustration showing a normal valve and a faulty valve.
a A normal valve
b A faulty valve

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 surgical alternatives to a Nissen fundoplication such as a partial wrap and placing magnetic beads around your oesophagus (linx procedure).

What does the operation involve?

The operation is performed under a general anaesthetic and usually takes 1 to 2 hours.

Your surgeon will use laparoscopic (keyhole) surgery as this is associated with less pain, less scarring and a faster return to normal activities.

They will make several small cuts on your abdomen so they can insert tubes (ports) into your abdomen. Your surgeon will insert surgical instruments through the ports along with a telescope so they can 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.

What complications can happen?

Some complications can be serious and can even cause death.

General complications of any operation

  • pain
  • bleeding
  • unsightly scarring of your skin
  • developing a hernia in the scar
  • infection of the surgical site (wound)
  • blood clot in your leg
  • blood clot in your lung

Specific complications of this operation

Keyhole surgery complications

  • damage to structures such as your bowel, bladder or blood vessels
  • developing a hernia near one of the cuts
  • surgical emphysema (crackling sensation in your skin caused by trapped carbon dioxide gas)

Nissen fundoplication complications

  • pneumothorax, where air escapes into the space around your lung
  • making a hole in your oesophagus or stomach
  • tear of the stitches used for the wrap
  • damage to your liver
  • damage to your spleen
  • difficulty swallowing for a few months

Long-term problems

  • continued difficulty swallowing where you cannot swallow most foods normally
  • incomplete control of reflux symptoms
  • weight loss
  • abdominal discomfort
  • diarrhoea
  • tissues can join together in an abnormal way

How soon will I recover?

You should be able to go home the next day.

You should be able to return to work after a few weeks, depending on how much surgery you need and your type of work.

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.

You should make a full recovery, with the symptoms of acid reflux gone or much improved.

Summary

Acid reflux can cause heartburn or acid in your mouth. The acid can cause the lining of your oesophagus to become inflamed or scarred. Surgery may be recommended if your symptoms continue while you are taking medication.

IMPORTANT INFORMATION

The operation and treatment information on this page is published under license by Healthdirect Australia from EIDO Healthcare Australia and is protected by copyright laws. Other than for your personal, non-commercial use, you may not copy, print out, download or otherwise reproduce any of the information. The information should not replace advice that your relevant health professional would give you. Medical Illustration Copyright © Medical-Artist.com.

For more on how this information was prepared, click here.

Learn more here about the development and quality assurance of healthdirect content.

Last reviewed: September 2020


Back To Top

Need more information?

These trusted information partners have more on this topic.

Healthdirect 24hr 7 days a week hotline

24 hour health advice you can count on

1800 022 222

Government Accredited with over 140 information partners

We are a government-funded service, providing quality, approved health information and advice

Australian Government, health department logo ACT Government logo New South Wales government, health department logo Northen Territory Government logo Government of South Australia, health department logo Tasmanian government logo Government of Western Australia, health department logo