A Laparoscopic Nissen Fundoplication is a procedure used to help control the symptoms of gastroesophageal reflux disease (GERD).  The symptoms of GERD can include chronic heartburn and other problems related to stomach acid washing up into the esophagus.  This occurs because of a weakness in the lower esophageal sphincter (LES), which is a valve-like muscle that separates the esophagus from the stomach. GERD can be associated with a hiatal hernia, a condition in which a part of the stomach bulges up into the chest cavity.

Laparoscopic Nissen fundoplication works by tightening and improving the function of the LES muscle.  This procedure can provide relief for those with chronic heartburn whose symptoms are not controlled with diet and lifestyle changes or medications.  The operation is performed by repairing the hiatal hernia (if one is present), and wrapping or “plicating” the top part of the stomach (called the fundus) around the LES muscle to strengthen the valve.

In most cases, this operation can be performed laparoscopically, which leads to improved postoperative pain and faster recovery.

Because the operation leads to a tightening of the lower esophageal sphincter, some people will experience difficulty swallowing some foods for a few weeks after surgery.  Also, abdominal pain and bloating can occur after eating foods that distend the stomach.

Following your surgeon’s dietary instructions carefully will help to minimize these symptoms.  Your dietary recommendations may vary, but these are some general guidelines:

• Multiple small meals
• Eat or drink slowly
• chew your food well
• Sit upright while eating or drinking
• Avoid extremely hot or cold foods
• Avoid carbonated drinks
• Avoid dry meats and breads
• Avoid swallowing air (do not chew gum or drink through a straw)
• Avoid foods that can cause gas and distension (for example beans, raw vegetables, fiber supplements)
• For bloating, try taking Gas-X (available over the counter)

Your diet will progress in stages after surgery, beginning with clear liquids and progressing as tolerated to a regular diet.  Your surgeon will guide you in how quickly you can advance your diet.  If you experience any problems with any one of these stages, drop back down to the previous stage.

Stage 1:  Clear Liquids – starts right after surgery, may be continued for up to a few days after surgery.  Your surgeon will tell you when to transition to stage 2.  Remember: no carbonated beverages!

Stage 2:  Soft Diet – usually continues for the first week after surgery.  This generally includes foods that you could eat if you didn’t have teeth. Go back to stage 1 if you have any problems.

Stage 3:  Transition to Regular Diet – after the first week, continue with the soft diet, but start to introduce more challenging foods, one at a time.  Drop back to stage 2 as needed for bloating or difficulty swallowing.

Stage 4:  Regular Diet