Operation | Reflux

Operation

The principle of every reflux operation is to improve the function of the lower sphincter muscle of the esophagus. There are various technical procedures that vary depending on the clinic and the competence of the surgeon. The most common operation uses part of the stomach to strengthen the lower sphincter.

For this purpose it is placed around the esophagus as a cuff and fixed to it. This procedure is called “Fundoplication according to Nissen”. In this procedure, the oesophagus is wrapped around 360° and thus completely surrounds the oesophagus.

Alternative methods encase the esophagus only in 180° or 270°. The advantage of this operation is that no foreign material is introduced into the body.Other methods do this without changing the shape of the stomach. For this purpose, bands or rings are inserted around the esophagus.

However, they are identical in their principle of action. Which operation is the best or correct one must be decided individually, depending on which procedure is suitable for the patient’s physical conditions and wishes. A reflux ring is a magnetic ring inserted around the lower sphincter of the esophagus, which supports the physiological function of the sphincter or, if necessary, even replaces it completely.

Visually, the ring can be imagined as a band of many magnetic beads that can be released from each other by pulling or pushing. In the body, this means that when food is ingested, the ring can expand in the lumen of the oesophagus under the weight of the food, allowing the food to pass into the stomach. Once it has passed through its structure, however, the force of attraction of the magnets is again greater than the pressure in the lumen of the empty esophagus and the ring contracts again.

The effect is therefore that the stomach is always optimally sealed off from the esophagus when no food or fluid is being taken in. The challenge in this procedure is to determine the adequate attraction force of the magnets and the optimal diameter of the ring for the patient. A ring that is too wide does not seal the esophagus sufficiently, while a ring that is too narrow can severely impede passage in the form of swallowing difficulties.

In addition, the ring is a foreign body that can potentially trigger an intolerance reaction in the body. However, the advantage after a successful operation is that the affected person no longer needs to take medication against reflux and the stomach is retained in its original form.