Fundoplication

Fundoplication is referred to the surgical procedure that done to treat Gastroesophageal reflux disease (GERD). Under normal circumstances, the reflux of acid from the stomach into the esophagus is prevented by the lower esophageal sphincter, which remains contracted most of the time. In GERD patients the lower esophageal sphincter does not function normally as either its muscles are weak or they remain relaxed. Fundoplication is a surgical procedure that is used to strengthen the lower esophageal sphincter, thereby controlling the reflux of acid from the stomach into the esophagus. During the procedure, the upper part of the stomach (fundus) is gathered and sewed or sutured around the lower esophageal sphincter. The pressure at the lower end of the esophagus is increased after this procedure, thereby, decreasing reflux of acid. If hiatal hernia is also present along with GERD, then the hernia sac is also sutured so that it lies in the abdomen.

Paraesophageal

The hiatus is a normal opening in the muscle that separates the chest cavity from the abdomen which moves up and down with breathing. Although the hiatus is a normal opening, there are occasions when this opening enlarges and the stomach or other organs can slip up inside the chest. This occasion of an abnormally large opening of the hiatus is called a hiatal hernia. Paraesophageal hernias account for only 5% of all hiatal hernias. A paraesophageal hernia is a type of hiatal hernia where the junction of the stomach and the esophagus remains in place, but part of the stomach is squeezed up into the chest beside the esophagus.

Diaphragmatic hernia being laparoscopic sutured

Minimally Invasive Esophagectomy

The esophagus is a relatively simple organ but it does have several locations where problems are more likely. The most problematic area is at the bottom (technically, in the lower thoracic section) where the esophagus connects with the stomach – the gastroesophageal junction. At the junction is the lower gastroesophageal sphincter, a hole into the stomach controlled by a set of muscles that opens to allow food to enter the stomach, and closes to prevent stomach acid from entering the esophagus. When this sphincter is not functioning properly, especially as a chronic long-term condition, there are many potential problems, some of which may lead to cancer.

Esophagus transversing diaphragmatic hiatus

Acid Reflux

Acid reflux occurs when stomach contents leak out into the tube connecting the mouth to the stomach. Common symptoms include heartburn, an unpleasant taste in the mouth and difficulty swallowing. Less commonly, throat pain, nausea, coughing and increased salivation may also be observed, and frequent reflux is associated with an increased risk of tooth decay due to acid erosion. Most people will experience occasional episodes of symptomatic acid reflux, and it is usually no cause for concern.

Esophagus

From the back of the mouth (the pharynx) to the top of the stomach, the esophagus is a muscular tube for foods and liquids. It’s relatively tough and resilient as organs go, built to take most of the material human beings ingest. For the most part, it’s not a very complicated organ. Depending on the height of the person, it’s about 10 inches long (25 cm) and 1 inch in diameter (2-3 cm). The esophagus’ geography usually divides into three sections: cervical at the top, thoracic in the middle, and abdominal at the bottom.