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But now they can be rid of heartburn and those sleepless nights, thanks to a new a minimally invasive videoscopic surgical procedure that improves the natural barrier between the stomach and the esophagus.
Millions of people in this country suffer from chronic heartburn, or what is known as gastroesophageal reflux disease (GERD). Of that number, there are some for whom medication provides no relief. Many of these people are finding that videoscopic surgery -- in which surgeons operate using a small instrument called a laparoscope that is connected to a video monitor -- can be a long-term solution to an everyday problem.
"Laproscopic anti-reflux surgery has an 85 to 90 percent chance of controlling this disease and returning the patient to relatively normal dietary habits without the need for medications," said Keith S. Naunheim, M.D., professor of surgery and chief of the division of cardiothoracic surgery at the School of Medicine.
Chronic heartburn, or GERD, occurs when acid or food in the stomach surges back up into the esophagus -- the tube that carries food from the mouth to the stomach. Here, a muscular valve known as the lower esophageal sphincter (LES) acts as a regulator between the esophagus and the stomach. This valve usually keeps the acid from "refluxing," or backing up, into the esophagus. However, when the LES is not working properly, reflux occurs, causing a burning sensation in the chest and esophageal area.
During the videoscopic procedure to correct GERD, the surgeon makes a series of five to six small incisions, each less than one inch in length, creating a passageway for special surgical instruments, including the laparoscope. The laparoscope is then able to transmit images from the inside of the body to video monitors in the operating room, allowing the surgeon and staff to see the operative area on the screens. Next, the surgeon manipulates the instruments to wrap a portion of the stomach known as the gastric fundus, around the lower esophageal sphincter, which reinforces the valve and prevents the flow of acid back into the esophagus.
Until the advent of the videoscopic procedure, traditional surgery for GERD required surgeons to make a long incision in the abdomen or chest to gain access to the area in need of repair. Because the videoscopic surgery is less invasive, scarring is reduced, and many patients can leave the hospital in two-to-five days, instead of the nine days required for traditional surgery. In addition, recovery time can be as little as seven to 14 days, compared with four to six weeks for traditional surgery.
"The minimally invasive approach for anti-reflux surgery has markedly decreased the post-operative level of discomfort and the length of hospitalization," Naunheim said. "Patients are also able to return to normal activities in a much shorter period of time."
Most major health insurance plans cover the cost of videoscopic surgery, the overall cost of which is approximately the same as traditional surgical methods. Videoscopic surgery now can be performed to provide relief from conditions that were once only treatable with traditional, or what is known as "open," surgery. In addition to the procedure for GERD, videoscopic procedures are available for gallbladder removal, hysterectomy, hernia repair, appendectomy, colon surgery and for urinary stress incontinence. For more information about videoscopic surgery for chronic heartburn or other minimally-invasive procedures, call SLUCare at 268-5880.
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