Fundoplication - Know What Is It!

Fundoplication is a kind of surgery which aims to prevent stomach contents from going back to the oesophagus. The operation is conducted by wrapping the upper half of the stomach, close to the lower portion of the oesophagus, thereby tightening the outlet of the oesophagus as it empties into the stomach. In maximum cases, this surgery of fundoplication gets performed by a paediatrician by using a small telescope and small instruments, which get placed through few incisions, in the size of a band-aid on the abdomen.

Why is the surgery necessary?
Fundoplication is usually recommended for children who have the following problems and symptoms, which include:

• Children who have complications or persistent symptoms related to gastroesophageal reflux (GER), which do not improve through medication.
• The symptoms of this problem include vomiting, oesophagitis gastrooesophageal stricture, recurrent pneumonia, breathing problems and insufficient growth.
• Before undergoing the surgery, a paediatrician can perform some tests on the child to confirm GER, like pH probe study or oesophogram.

How is the surgery performed?
The surgery of fundoplication is conducted in the following manner:

• As mentioned earlier, the surgery is performed with the use of a small telescope and miniaturized instruments that are placed through 3-4 band-aid size cuts on the abdomen.
• The surgery is performed within two to three hours and a child might need to stay back in the hospital for 2-3 days after the surgery.
• After the operation, when the child is in hospital, he/she would receive intravenous fluids along with pain medication.
• As and when the child feels well, he/she would be allowed to eat, drink as well as take medicines by mouth.
• For some patients, a gastrostomy tube is put inside the mouth to ensure the feedings get administered and the air gets released. The release of air is known as venting.
• It would be difficult for the child to burp for a number of weeks after a fundoplication has been done. So, the venting ensures that air leaves the stomach, which would lead to a decrease in bloating and thus keep the child comfortable.

Diet
Little bit of time would be needed for a child to fully recover from this surgery and for food to go through comfortably into his/her stomach. The first two weeks would involve only liquid diet including:

• Water
• Juices
• Milk
• Milkshakes
• Ice Cream
• After this in the 3rd and 4th weeks, his or her foods can include mashed potatoes, pasta, fish, cereal, cheese.
• Then after one month, they can slowly resume their usual diet.

Pain Management
Pain medication as per prescription is not required to be followed on a routine basis after discharge. When the child is back home, they only give either Acetaminophen or Ibuprophen.