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Laparoscopic Myotomy and Fundoplication for Achalasia
WHAT YOU NEED TO KNOW:
What is laparoscopic myotomy and fundoplication?
A laparoscopic myotomy is a procedure to open the valve between your esophagus and stomach. A fundoplication is a procedure to wrap part of your stomach around part of your esophagus. This prevents acid reflux. A laparoscope (tube with a camera on the end) is used to do the surgery, along with other tools.
How do I prepare for this procedure?
- Your healthcare provider will tell you how to prepare. Arrange to have someone drive you home after the procedure.
- You may need to be on a liquid diet for at least 24 hours before the procedure. Your provider will give you instructions for your liquid diet if it is recommended.
- Your provider will use a test called a manometry to measure muscle strength in your esophagus. He or she will tell you when to have the manometry and how to prepare.
- Tell your provider about all medicines you currently take. He or she will tell you if you need to stop any medicine for surgery, and when to stop.
- Tell your provider about all your allergies, including allergic reactions to anesthesia.
What will happen during this procedure?
- General anesthesia will be given to keep you asleep and free from pain during the procedure. Your healthcare provider will make 5 small incisions in your abdomen. He or she will do the procedure with a laparoscope put through the incisions.
- Your provider will open the area between your esophagus and stomach. This will make it easier for food to get to your stomach when you to swallow. Then your provider will wrap part of your stomach around your esophagus. This prevents stomach acid from going up into your esophagus. Your provider will fix the part of your stomach in place with stitches.
- A drain may be placed to remove extra fluid from the surgery area. The incisions will be closed and covered with bandages to prevent an infection.
What should I expect after this procedure?
- The procedure area may be swollen. You may also have pain. These should get better in a few days.
- You may have bloating for about a month.
- You may be able to have liquids or some foods the day after the procedure.
- Your healthcare provider will tell you if you should stay on a liquid diet after surgery. You may need to work up to solid foods.
- You will be given a list of foods to avoid for 2 weeks. These include meat, liquid that contains carbonation (such as soft drinks), and bread.
What are the risks of laparoscopic myotomy and fundoplication?
You may bleed more than expected. You may develop an infection in the procedure area, or in an organ. The inner lining of your esophagus may be perforated. This means holes are made in the lining. You may need antibiotics or another surgery to fix this problem. A hernia may develop where you had an incision. You may develop a bowel obstruction (blockage). Your intestines or a blood vessel may be injured. Your healthcare provider may change your procedure to open surgery if this happens. You may still have problems swallowing, or the problems may come back later. Some stomach acid may still go into your esophagus. You may develop dumping syndrome. This means food goes too fast from your stomach to your intestines. This can cause bloating, nausea, or diarrhea after you eat.
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