A fundoplication is an operation done to control gastro-esophageal reflux disease (GERD) which has not responded to medical treatment or which has resulted in a complication which makes continued medical therapy unsafe. The surgery involves using the stomach to build a one-way valve by wrapping the upper portion of the stomach around the lower end of the esophagus. This valve prevents food, liquids, and stomach juices from refluxing back up into the esophagus. This operation does not make the patient “normal,” because the normal individual normally has a little reflux about every 10-15 minutes for the first two hours following a meal. After a fundoplication there should be no reflux after a meal; so, that’s not normal. For this reason, fundoplication surgery is only used in patients whose symptoms can’t be controlled with medications or who have had repeated pneumonias, a life-threatening episode, or have developed an esophageal stricture.
1. As with any operation, there are possible complications which may result from fundoplication surgery. Many of the patients who would benefit from a fundoplication have other illnesses which may increase the risk of anesthesia or require observation in the intensive care unit after the operation or require ventilator support after the operation. Below are listed the most common, but not all possible, complications following this operation.
2. Depending on your child’s needs your surgeon may have written a prescription for a narcotic for pain. Tylenol or Ibuprofen may be all that your child requires for pain relief, but if he needs something stronger, you may use the prescription medication.
3. Your surgeon or gastroenterologist will discuss your child’s feeding schedule with you prior to discharge. This schedule is designed to prevent your child from retching during or after feedings. This is especially important during the first six weeks after surgery. If your child is retching with feedings, contact our office during office hours.
4. You may remove the bandage on the navel 24 hours after the surgery.
5. Your child may have a sponge bath 24 hours after surgery. Do not scrub or rub the incisions; blot them dry. You may give him/her a tub bath or he/she may shower 48-72 hours after surgery, but do not let the incisions soak under water for 10 days. No swimming is allowed for two weeks following surgery.
6. Depending on your child’s age and development, your child may walk around outside and climb stairs, but he/she will walk around for 10-15 minute, and then, he/she will be worn out and will have to sit down or lay down to rest. It takes most children five to seven days to get their energy and exercise tolerance back. Don’t let them go to the mall, because he/she will feel exhausted after about 15 minutes.
7. If your child is school age, he/she may return to school seven to ten days after surgery. Your surgeon will give him/her permission when he/she may resume physical education/contact sports.
8. You should watch for these signs of infection: (a) if rather than feeling better and better each day, your child is hurting more and more; (b) if your child starts to run a fever higher than 100.6º; or (c) one of the incisions starts to look bright red. If any of these occur, you should call the office during office hours.
9. Your surgeon will need to see your child in follow-up in his office two to three weeks after surgery. If you have not already arranged an appointment, please call the office today or tomorrow morning and schedule one.
Postoperative Check: Your surgeon will want to see your child following surgery. If you have not already arranged a follow-up appointment, please call our office to do so, the afternoon after surgery or the following morning. If you have any questions or concerns, do not hesitate to call our main office number at (423) 267-0466.