Nissen Fundoplication HF#5344

Gastroesophageal reflux disease (GERD) is a common condition in which stomach contents (acid, digestive juices, partially digested food) backs-up, or refluxes into the esophagus.  Normally, there is a valve that prevents stomach contents from moving back up into the esophagus.  In people with GERD, this valve is not working properly.  In many people, this is related in part to the presence of a hiatal hernia.  Nissen fundoplication is a procedure designed to stop GERD.  In a fundoplication, also commonly called a wrap, the top of the stomach is wrapped around the lower portion of the stomach, effectively recreating the antireflux valve that has stopped working in people with GERD.  This procedure is most often performed laparoscopically through several (about 5) small incisions.  In rare cases, a larger (open) abdominal incision is necessary.  If you have a hiatal hernia, this is usually fixed at the time of the fundoplication. 

 

Day before Surgery-Bowel Prep

 

1.    You will need to buy 1-(10 oz.) bottle of Magnesium Citrate.  You can find this at a pharmacy without a doctor’s order.  It tastes better chilled. Be sure you have reviewed your medicine list with the nurse practitioner in case there are any that you will need to stop. Please call with any questions.  

 

2.    Eat a light breakfast and lunch.

 

3.    Drink only clear liquids after lunch until 4 hours before your surgery begins.

Clear Liquids:

 

Water	Homemade clear gelatin (Jell-O®) no Jell-O cups
Broth	Soda
Juices with no pulp. grape, apple or cranberry are okay	Coffee or tea.  No milk or creamer. Gatorade
Popsicles	No alcohol
Hard Candy	No dairy products

 

4.    At 2 pm, drink the Magnesium Citrate 10 oz.  

 

5.    You may keep drinking only clear liquids until 4 hrs before your surgery begins.

 

6.    Shower before bed and in the morning before you leave home.  

 

After Surgery

 

Diet

 

After surgery your diet will be changed slowly.  Each person’s tolerance for food varies.  Most of our patients go home on a pureed diet for two weeks.

 

Keep your stomach from stretching.  You should eat small frequent meals after surgery.  Limit fluids with meals.  This will help prevent your stomach from being overfull.  Small bites and chewing your food well helps you to swallow and digest your food better.

 

Avoid foods that cause gas.  Do not drink no carbonated beverages or use straws.

 

Wound Care

 

• Wear loose clothing.
• You may shower the day after your surgery
• Small areas of bruising at your incision sites are common.
• Check your wounds daily and report problems such as:

Increased redness, swelling or warmth.

Drainage such as blood or pus.

Temperature over 100.4° F by mouth for two readings taken 4 hours apart.

Excess bruising.

 

Activity

 

• We will help you walk the day of your surgery.  Plan to take more that 4 walks a day.
• Plan for rest times during the day.  You may feel tired and have muscle aches for a few days
• No driving while taking narcotic pain pills.
• No strenuous activity or pulling, pushing, and twisting until okayed by your doctor.
• Do not lift more than 25 pounds for 4 weeks. 
• Check with your doctor before you return to work. 
• Sex may be resumed when you feel ready.
• Avoid all tobacco including second hand smoke.

 

Pain Relief

 

Expect pain after surgery.  Your pain pills will help manage the pain.  If you had laparoscopic surgery, you may have pain in your neck and shoulders from the gas in your abdomen during surgery.  Walking may help to decrease this pain.  Using a heating pad may also help to relieve some of this pain.  Please use for no longer than 15 minutes per hour at a low setting.

 

When to Call the Doctor

 

• Problems swallowing
• Heartburn that comes back
• If you have not had a bowel movement 3 days after surgery, you may need a laxative.
• Temperature over 100.4 ºF by mouth, for two readings taken 4 hours apart
• Painful bloating or cramping
• Increased redness or warmth of incisions
• Bleeding or pus from the wounds
• Pain not controlled by pain pills

 

Follow-Up

 

Your will see your surgical team 2 weeks after surgery.

 

Phone Numbers

 

Surgery Clinic:  (608) 263-7502.  This is a 24 hour number.

 

After hours, weekends and holidays ask for the doctor on call for Dr.__________________.  Leave your name and phone number with the area code.  The doctor will call you back.

 

Toll Free: 1 800-323-8942.

 

 

The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.

Last Updated: 11/17/2010

Copyright © 11/17/2010 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#5344

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