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Robotic Surgery at USC

Robotic Surgery for Gastroesophageal Reflux Disease (GERD)

About GERD

Your esophagus is the tube that carries food from your mouth to your stomach. Gastroesophageal reflux disease, commonly called GERD, occurs when a muscle at the end of your esophagus does not close properly. This allows stomach contents to leak back, or reflux, into the esophagus and irritate it.

gastroesophageal reflux disease (GERD) GERD occurs when the lower esophageal sphincter (valve) between the stomach and esophagus is weak or opens abnormally. Stomach juices reflux into the esophagus and may injure the esophagus and cause symptoms of heartburn or regurgitation.

GERD is a very common condition affecting 5 to 7% of the world’s population and many of those people go untreated because they don't know that the symptoms may signal a more serious condition.

More info: Gastroesophageal Reflux Disease

da Vinci® Surgery for GERD

If your doctor recommends surgery to treat GERD, you may be a candidate for a safe, effective and minimally invasive procedure – da Vinci Surgery. Using the most advanced technology available, the da Vinci System enables your doctor to perform this delicate operation with breakthrough precision, superior vision, dexterity and improved access to the affected area. da Vinci Surgery offers GERD patients many potential benefits over traditional surgery, including:

  • Short hospital stay
  • Low risk of complications
  • Low bloodloss and need for transfusions

da Vinci Robotic Surgery - Surgeon's console and Patient table

As with any surgery, these benefits cannot be guaranteed, as surgery is patient – and procedure-specific. All surgeries carry risks of major complications. Before you decide on surgery discuss treatment options with your doctor. Understanding the risks of each treatment can help you make the best decision for your individual situation.

Causes & Risk Factors

Anyone, including infants and children, can have GERD. Causes and risk factors for GERD can include: hiatal hernia (part of the stomach moves above the diaphragm - the muscle separating the chest and abdominal cavities), scleroderma and obesity; smoking, and possibly alcohol may also increase the risk of GERD.

GERD can also be brought on or worsened by pregnancy and medications for certain conditions (seasickness, asthma, heart disease, high blood pressure, Parkinson’s Disease, excessive menstrual bleeding, insomnia and depression).

Symptoms

You may feel a burning in the chest or throat which is commonly called heartburn. Sometimes, you can taste stomach fluid in the back of the mouth. This is known as acid indigestion. If you have these symptoms more than twice a week, you may have GERD. Other symptoms of GERD can include:

  • Feeling that food may be left trapped behind the breastbone
  • Heartburn increases by bending, stooping, lying down, or eating
  • Nausea after eating
  • Difficulty swallowing
  • Regurgitation of food

Treatment

If it is not treated, GERD can lead to more serious health problems. In some cases, you might need medication or surgery. Your doctor will discuss treatment options with you in detail, which may include:

Lifestyle / Dietary Changes

Some GERD patients have found that following lifestyle and dietary changes can ease their symptoms:

  • Avoid bending over or exercising just after eating
  • Avoid foods and beverages that trigger symptoms  
  • Avoid clothes or belts that fit tightly around your waist
  • Do not lie down with a full stomach
  • Do not smoke.
  • Eat smaller meals
  • Lose weight, if you are overweight
  • Reduce stress
  • Sleep with your head raised about 6 inches (tilt entire bed, or use a wedge under your body, not just with normal pillows)

Medication

Over-the-counter antacids after meals and at bedtime may help some GERD patients, but the benefits do not last very long and certain medications have side effects of diarrhea or constipation. Other over-the-counter and prescription drugs can provide longer relief of symptoms, but they work more slowly than antacids. Your doctor or nurse can tell you how to properly take these drugs.

Surgery

When medication, lifestyle or dietary changes do not ease your symptoms, GERD surgery, called Nissen fundoplication, may be recommended.

During surgery, the upper curve of the stomach (fundus) is wrapped around the esophagus and sewn into place so that the lower portion of the esophagus passes through a small tunnel of stomach muscle. Surgery strengthens the valve between the esophagus and stomach, which stops acid from backing up into the esophagus as easily.

If the procedure is done using open surgery, a large incision is made through the abdomen or chest. This procedure can also be done using a laparoscopic surgical technique which is less invasive but has certain limitations due to the long-handled, rigid instruments used.

Heartburn and other symptoms should improve after surgery, but your doctor may recommend that you still take medication if your heartburn continues.

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Upper G.I. and General Surgery

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