What is a laparoscopic reflux operation?

A reflux operation involves the surgical tightening of the junction between the oesophagus (food pipe) and the stomach. This operation may be done laparoscopically (i.e. with the help of a video camera through tubes in very small cuts in the abdomen).

Anaesthetic

This procedure will/may require an anaesthetic.

What are the risks of this specific procedure?

There are risks and complications with this procedure.
They include but are not limited to the following:

General risks:

  • Infection can occur, requiring antibiotics and further treatment.
  • Bleeding could occur and may require a return to the operating room. Bleeding is more common if you have been taking blood thinning drugs such as Warfarin, Asprin, Clopidogrel (Plavix or Iscover) or Dipyridamole (Persantin or Asasantin).
  • Small areas of the lung can collapse, increasing the risk of chest infection. This may need antibiotics and physiotherapy.
  • Increased risk in obese people of wound infection, chest infection, heart and lung complications, and thrombosis.
  • Heart attack or stroke could occur due to the strain on the heart.
  • Blood clot in the leg (DVT) causing pain and swelling. In rare cases, part of the clot may break off and go to the lungs.
  • Death as a result of this procedure is possible.

Specific risks:

  • The laparoscopic/keyhole method may fail and the surgeon may need to do open surgery in 1 in 20 cases.
  • Damage to large blood vessels, or gut when the sharp trocar and cannula are inserted to provide access and gas insufflation. This may need fluid replacement or further surgery.
  • Rarely gas, which is fed into the abdominal cavity, can cause 1 in 100 people. This can be life threatening.
  • Deep bleeding in the abdominal cavity and this may need further surgery.
  • Damage to the oesophagus that may lead to infection in the chest. This may need further surgery.
  • Damage to the bowel which may cause leakage of bowel fluid. This may need further surgery.
  • Damage to the spleen, in which case it will have to be removed.
  • Especially in a male, there may be difficulty passing urine and a tube may need to be inserted into the bladder.
  • Infections such as pus collections in the abdomen cavity. This may need surgical drainage.
  • The bowel movement may be paralyzed or blocked after surgery and this may cause building up of fluid in the bowel with bloating of the abdomen and vomiting. Further treatment may be necessary for this.
  • Difficulty in swallowing, belching and vomiting after the operation. This is irreversible.
  • Damage to the vagus nerve, which can delay stomach emptying. This may require further surgery.
  • Sometimes adhesions (bands of scar tissue) develop in the abdomen and the bowel may block – this is a short and long term complication and may need further surgery.
  • There may be a recurrence of the problem despite adequate surgery.
  • In some people, healing of the wound may become thickened and red and may be painful.
  • Increase risk in obese people of wound infection, chest infection, heart and lung complications and thrombosis.
  • Increased risk in smokers of wound and chest infections, heart and lung complications and thrombosis.