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Laparoscopic Fundoplication / Hiatal Hernia Surgery Werribee St Vincent’s Private Hospital

Introduction

Laparoscopic fundoplication is a commonly performed minimally invasive procedure to treat gastro-oesophageal reflux disease (GORD), typically done in conjunction with hiatus hernia repair. A hiatus hernia happens when part of the stomach pushes up through the diaphragm, contributing to acid reflux and other symptoms. The goal of surgery is to restore normal anatomy and prevent reflux.

This page provides an overview of the procedure, outlining its benefits, risks, and expected recovery, with information sourced from reliable medical references for educational use.

Hiatal Hernia Surgery Werribee St Vincent's Private Hospital

What the Procedure Involves

Typically performed under general anaesthesia, the procedure uses laparoscopic (keyhole) techniques that involve making small incisions in the abdomen. A laparoscope, a thin tube with a camera, is inserted to assist the surgeon.

Key steps include:

  • Repairing the hiatus hernia includes pulling the stomach back into the abdomen and securing the diaphragm opening (hiatus) with permanent stitches. A mesh may be used in cases of large hernias to reinforce the repair.
  • During the fundoplication procedure, the upper part of the stomach (fundus) is wrapped around the lower oesophagus, creating a one-way valve to prevent stomach acid from refluxing. The Dor fundoplication is an anterior 180-degree wrap.

The surgery typically takes 2-3 hours and is considered low-risk when performed by experienced surgeons.

Benefits

The primary benefits of laparoscopic fundoplication and hiatus hernia repair include:

  • Effective control of GERD symptoms like heartburn, regurgitation, and chest pain, often decreasing or eliminating the reliance on long-term medications such as proton pump inhibitors (PPIs).
  • Helps prevent complications related to untreated GERD or hiatus hernia, including oesophageal damage, Barrett’s oesophagus, or aspiration.
  • Improved quality of life, with studies indicating high patient satisfaction and symptom relief lasting 8-10 years or more in many cases.
  • The minimally invasive approach results in smaller scars, less pain, and faster recovery compared to open surgery.

This procedure is particularly beneficial for patients who do not respond well to medical therapy or have large hernias.

Risks

As with any surgery, there are potential risks, though they are generally low with laparoscopic techniques (mortality rate <1%). Possible complications include:

  • Immediate risks: Infection, bleeding, injury to nearby organs (e.g., oesophagus, spleen, or lungs), or anaesthesia-related issues.
  • Post-operative issues: Difficulty swallowing (dysphagia), which usually resolves within weeks; gas bloating or inability to belch/vomit; diarrhoea; or recurrence of the hernia or reflux symptoms.
  • Rare but serious complications: Gastric perforation, hernia recurrence, or the need for reoperation.

Expected Recovery Time

Recovery from laparoscopic fundoplication and hiatus hernia repair is generally quicker than recovery from open surgery.

Hospital stay: 1-3 days.

  • Initial recovery: Patients often resume light activities within a few days but should avoid heavy lifting for 4-6 weeks.
  • Diet: Start with liquids or soft foods for the first few weeks to allow healing, then gradually reintroduce normal foods.
  • Return to work/normal routine: 1-3 weeks for desk-based jobs, up to 4 weeks for physically demanding roles.
  • Full recovery: Most patients feel back to normal within 4-6 weeks, with follow-up appointments to track progress.

To ensure optimal recovery, follow your surgeon’s post-operative instructions, including guidelines for pain management and diet.

References

Efthymiou V, et al. (2024). A short-term outcomes and cost systematic literature review and meta-analysis comparing robotic-assisted and laparoscopic antireflux surgery and hiatal hernia repair. Surg Endosc. PMID: 38842610.

Ueda T, et al. (2023). A Narrative Review on Treatment of Giant Hiatal Hernia. Cureus. PMID: 36927045.

Furtak A, et al. (2024). New Developments in Anti-Reflux Surgery: Where Are We Now? Visc Med. PMID: 39398392.

Zhou T, et al. (2023). What works best in hiatus hernia repair, sutures alone, absorbable mesh or non-absorbable mesh? A systematic review and network meta-analysis of randomized controlled trials. Ann Surg. PMID: 36563005.

Ward MA, et al. (2023). The Role of Biologic Mesh and Fundoplication in the Surgical Management of Hiatal Hernias: A Multicenter Evaluation. Surg Endosc. PMID: 37494890.

Chang E, et al. (2023). Laparoscopic large hiatus hernia repair with mesh reinforcement: a systematic review and meta-analysis. Hernia. PMID: 37010656.

Andreou A, et al. (2024). Laparoscopic total (Nissen) versus posterior (Toupet) fundoplication for gastro-oesophageal reflux disease in adults. Cochrane Database Syst Rev. PMID: 38493409.

Hunter JG, et al. (2025). Individualizing the choice of surgical therapy for gastroesophageal reflux disease. Ann Surg. PMID: 39964431.

Spechler SJ, et al. (2022). Patient-reported outcomes in 645 patients after laparoscopic fundoplication for gastroesophageal reflux disease. Ann Surg. PMID: 36307333.

Ayazi S, et al. (2024). Surgical treatment strategies for gastroesophageal reflux after bariatric surgery. Ann Esophagus. PMID: 39534257.

Important Disclaimers

This information is general in nature and is not intended to replace professional medical advice, diagnosis, or treatment. Individual circumstances vary, and the suitability of this procedure should be discussed with a qualified healthcare professional. Always consult your doctor or surgeon for personalised advice based on your health status.