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Overview


Gastroesophageal reflux disease (GERD) is the movement of food and acid from the stomach back up into the esophagus.  GERD may cause symptoms such as throwing up, gagging, chest pain, or breathing problems.  Children with severe reflux may also have many ear, nose and throat infections.  They may also have poor weight gain.  Children whose reflux does not improve may need a surgery called fundoplication.

Laparoscopic Nissen Fundoplication Surgery, Nissen Fundoplication India, Laparoscopic Nissen Fundoplication Surgery Treatment Delhi India, Laparoscopic Nissen Fundoplication You and your doctors feel that surgery is the best choice for treating your child’s reflux disease.  Your child will receive general anesthesia during the operation.  A 3-4 inch cut will be made.  The surgeon will then wrap a portion of your child’s stomach around the bottom of her esophagus, making a one-way valve.  This valve will allow food and drinks to go down into your child’s stomach but stops stomach contents from flowing back up into the esophagus. 

Your child also may or may not need a gastrostomy tube (G-tube), which is placed during surgery through the stomach wall and into the stomach.  A G-tube can be used for feedings, giving medicines, and venting extra air or fluid from the stomach.  You and your surgeon will discuss this before surgery.

After surgery, your child will stay in the hospital for 4-5 days before going home.  Your child will return to see the doctor in clinic 2-3 weeks after that.

Incision Care

  1. Your child’s wound should heal in 1-2 weeks.  The stitches will dissolve.
  2. Do not put ointments, powders, or creams on the wound.
  3. Your child may shower 3 days after surgery and may bathe after 7-10 days.
  4. Check your child’s wound daily for:
    • Redness and/or warmth at the site
    • Pus-like drainage
    • Increased swelling or bleeding
  5. For 1 year after the wound is healed, apply SPF 30 sunscreen to the scar when out in the sun.

Activity

  1. For the first 4 weeks, your child should not lift any heavy objects.  Lifting puts extra strain on the wound and increases the chance of problems.
  2. After 4 weeks, your child may increase the level of his activity and play.  If you are not sure if it is safe, check with your doctor.
  3. Check with your doctor before your child returns to gym class and recess.
  4. Your child may return to school when he feels up to it.

Pain Relief

It is normal for your child to have some pain.  Pain medicine will be prescribed for your child.


Diet

Your child will be on a full liquid or soft diet until she returns to see the doctor (about 2-3 weeks).  She will need to eat slowly and chew her food well.  Remember to have your child drink slowly and in small amounts.

If your child has not had a bowel movement in 3 days, you may want to use a stool softener (Docusate, Colace), a bulk fiber laxative, or glycerin suppository.  They can be bought at your local drug store.

When to Call the Doctor

  • Constipation not relieved by stool softener or glycerin suppository
  • Fever above 100.4° F (by mouth) for 2 readings taken 4 hours apart
  • Excess swelling
  • Increased redness or warmth at the wound site
  • Large amount of bloody or pus-like drainage
  • Increased pain not controlled by pain medicine
  • Rapid or excess bruising.  (Some bruising is normal).


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