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Nissen Fundoplication

Treatments and Procedures

What Is Nissen Fundoplication? 

 

Nissen fundoplication is a surgical procedure used to treat persistent acid reflux that has not responded to lifestyle changes or medication. It is most commonly recommended for people with gastroesophageal reflux disease (GORD) who continue to experience troublesome symptoms despite treatment with proton pump inhibitors.

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It involves wrapping the upper part of the stomach around the lower end of the oesophagus (also known as the food pipe) to strengthen the valve between the stomach and oesophagus. This helps prevent stomach acid from flowing back into the oesophagus and causing reflux.

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The operation is usually performed as a laparoscopic fundoplication, using minimally invasive keyhole surgery, allowing many patients to recover more quickly than with traditional open surgery.

 

Why Might You Need Nissen Fundoplication?  

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Nissen fundoplication may be recommended when acid reflux symptoms become persistent, severe or begin to affect your quality of life. Mr Hornby may recommend surgery if you have:

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  • Persistent heartburn

  • Severe acid reflux

  • Regurgitation of stomach contents

  • Chronic cough or throat irritation caused by reflux

  • Reflux despite medication

  • A hiatus hernia or hiatal hernia contributing to reflux

  • Long-term dependence on proton pump inhibitors

  • Complications caused by ongoing oesophageal reflux disease

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For many patients, surgery offers long-term symptom relief when medication alone is no longer effective.

How Does the Procedure Work?

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A nissen fundoplication operation is performed under general anaesthesia. During the operation:

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  1. Several small incisions are made in the abdomen.

  2. A laparoscope and specialised surgical instruments are inserted.

  3. The upper part of the stomach is mobilised.

  4. The stomach is wrapped around the lower oesophagus.

  5. The wrap is secured with sutures to strengthen the natural valve.

  6. If a hiatal hernia is present, it is usually repaired during the same procedure.

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The fundoplication procedure normally takes between one and two hours.

 

Laparoscopic Nissen Fundoplication

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Most patients undergo a laparoscopic nissen fundoplication, which uses a minimally invasive approach. Compared with traditional surgery, laparoscopic surgery may offer several advantages, including:

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  • Smaller incisions

  • Less postoperative discomfort

  • Reduced scarring

  • Shorter hospital stay

  • Faster recovery

  • Earlier return to everyday activities

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For most patients, this approach is considered the gold standard for GERD surgery.

 

For more information on conditions that may require nissen fundoplication, see our pages on Reflux Conditions.

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To learn more about related treatments and diagnostic procedures, see our pages on Laparoscopic Hernia Repair, Therapeutic Endoscopy, Diagnostic Endoscopy, and Upper GI Endoscopy.

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Preparing for Surgery

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Before your operation, Mr Hornby will carry out a thorough assessment to ensure surgery is appropriate. This may include:

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  • Reviewing your symptoms

  • Upper GI endoscopy

  • Oesophageal function tests

  • Imaging studies where required

  • Discussion of current medications

  • Pre-operative assessment

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You will also receive instructions about eating, drinking and medication before the procedure.

 

Recovery After Nissen Fundoplication

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If you are wondering what to expect after nissen fundoplication surgery, it is normal to experience:

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  • Mild discomfort around the wound sites

  • Temporary bloating

  • Difficulty swallowing during the early stages of healing

  • Tiredness

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Recovery following nissen fundoplication is usually straightforward. Many patients remain in hospital for one or two nights before returning home. Most patients gradually resume normal daily activities over the following few weeks.

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Mr Hornby will advise when it is safe to return to work, exercise and driving.

Diet After Surgery

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Following surgery, your diet will need to be introduced gradually. Initially, patients are usually advised to:

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  • Eat soft foods

  • Take small meals

  • Chew food thoroughly

  • Eat slowly

  • Avoid carbonated drinks during early recovery

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As healing progresses, most people return to a normal diet over several weeks. Mr Hornby will provide detailed dietary guidance based on your recovery.

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What Are the Benefits?

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For suitable patients, nissen fundoplication can provide long-term control of reflux symptoms. Potential benefits include:

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  • Relief from persistent heartburn

  • Reduced acid reflux episodes

  • Less dependence on medication

  • Improved sleep

  • Reduced regurgitation

  • Better quality of life

  • Prevention of further reflux-related damage to the oesophagus

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Are There Any Risks?

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Like all surgical procedures, nissen fundoplication carries some risks. Although serious complications are uncommon, possible risks include:

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  • Bleeding

  • Infection

  • Injury to surrounding structures

  • Difficulty swallowing

  • Gas bloating

  • Recurrence of reflux

  • Reaction to general anaesthesia

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Mr Hornby will explain any individual possible complications before your operation.

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What Are the Possible Side Effects?

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Temporary side effects following surgery may include:

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  • Bloating

  • Increased wind

  • Temporary difficulty swallowing

  • Mild discomfort around the wound sites

  • Reduced ability to burp during the early recovery period

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These symptoms usually improve as healing progresses.

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Is Nissen Fundoplication Right for You?

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Nissen fundoplication is an effective treatment for carefully selected patients with severe gastroesophageal reflux disease, particularly when medication no longer provides adequate symptom control. By strengthening the valve between the stomach and oesophagus, the operation can significantly reduce reflux and improve long-term quality of life.

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Following a full assessment, your surgeon, Steve Hornby, will recommend the most appropriate treatment based on your symptoms, investigation results and overall health.

1

Initial consultation

Book an appointment with Steve Hornby, consultant general surgeon, to discuss your symptoms, concerns, and medical history. You will have time to ask questions and receive clear information about possible next steps.

2

 Personalised treatment plan

Care tailored to you. Following your consultation, a clear treatment plan is created based on your diagnosis, needs, and goals. This may include further investigations, treatment options, or preparation for surgery where appropriate.

3

Treatment and recovery support

Care that continues beyond treatment. If surgery is required, it is delivered in modern clinical facilities, with recovery supported through onsite physiotherapy and follow-up care. Ongoing reviews ensure your recovery stays on track.

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Ready to talk things through?

 

If you have questions or would like to discuss your symptoms, we’re here to help. You’re welcome to call 01242 386579, email admin@thehornbygroup.com, or use the contact form to get in touch.

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