What is a fundoplication?

Fundoplication is a type of surgery to stop stomach contents from moving up into the food pipe (esophagus) by reinforcing the “valve” between the lower esophagus and stomach.

During a fundoplication, the upper portion of the stomach (fundus) is wrapped around the lower portion of the esophagus. This tightens the lower esophagus so that food and fluid can go down into the stomach but cannot return back up to the esophagus, which causes symptoms of gastroesophageal reflux disease (GERD).

Fundoplication can either be complete (commonly called Nissen fundoplication) or partial.

Why would a child need a fundoplication?

Fundoplication is recommended for children who have persistent symptoms related to GERD that are not improved by medical treatment and lifestyle changes.

Symptoms or complications of GERD where fundoplication can be considered include long-term inflammation of the esophagus (esophagitis), recurrent aspiration pneumonia (caused by breathing in food particles, stomach acid, or saliva), poorly controlled asthma related to GERD, long-term anemia from irritation or ulcers in the esophagus, and narrowing of the esophagus (esophageal stricture).

Children with hiatal hernias may also need fundoplication, depending on the severity of symptoms. A hiatal hernia is a condition in which the top part of the stomach (fundus) bulges above the diaphragm (the muscle that separates the chest cavity from the abdominal cavity) and into the chest cavity.

How is a fundoplication done?

Fundoplication may be done through an incision in the skin on the upper abdomen (open fundoplication), or it may be performed using a small camera and instruments placed through several smaller incisions (laparoscopic fundoplication).

It may take your child longer to recover from an open fundoplication than a laparoscopic fundoplication.

What can I expect after a fundoplication?

Edited by: Jubin Matthews, MD
March 2019

North American Society for Pediatric Gastroenterology, Hepatology and Nutrition
The Association of Pediatric Gastroenterology and Nutrition Nurses
North American Society for Pediatric Gastroenterology, Hepatology and Nutrition Foundation
The NASPGHAN Council For Pediatric Nutrition Professionals
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