Acidreflux.org.uk: “Wow that’s amazing didn’t you put it in and out it goes at one point and you never know the difference.”
Dr Brown: “That procedure is is kind of replacing our old procedure which was called a 24 hours ph probe test that test involved a small catheter which was passed nasally into the oesophagus and it was secured in place for hours at home while you’re going about activities um that was a little more uncomfortable for people because it is a catheter passed through the nose it’s not painful but it’s not the most pleasant experience necessarily.
What kind of surgeries is available to treat acid reflux?
Acidreflux.org.uk: ” If someone goes through you know some of these tests and they find out it is acid reflux and what do you do next what kind of surgeries I mean what would somebody expect you know and how do you approach that?”
Dr Brown: “The the surgery is designed to recreate what’s called the lower oesophagal sphincter so there’s an actual sphincter muscle which is present where the oesophagus ends and right where it joins the stomach and that is tight enough to prevent acid or stomach contents from refluxing up if that becomes dysfunctional such that it’s loose and not working people can tend to have reflux so the surgery is designed to recreate that sphincter mechanism so we actually take part of the stomach the stomach’s kind of a floppy organ and it’s a bit it has enough redundancy to it that we can take part of it and actually wrap it around that oesophagus area to recreate that sphincter mechanics so that’s one of the things we have to do is do the surgery with that wrap being loose enough so you can still swallow well but tight enough that things won’t back up on you.”
What happens after the acid reflux surgery?
Acidreflux.org.uk: “What happens now after you do the surgery? People would want it to be a permanent solution. What if things go wrong?”
Dr Brown: “That’s a good question and i think that’s been one of the criticisms of this surgical approach not everyone is a huge fan of doing a surgical approach for reflux and one of the criticisms is that over years the efficacy of the surgery might wane and data has shown that up between up 5 to 10 years after surgery most people have good control of the reflux still we’re talking upwards of percent of patients will still have good control of their reflux out beyond 10 years we don’t really know because studies haven’t followed patients that long really to know but there is some suggestion that with time people symptoms might start to reoccur and maybe they’ll start to require some medications again but when you survey those patients in the future and ask them how happy they were with their surgery they’re all very happy and pleased satisfaction scores are extremely high so my analogy to that is it’s a little bit like having a knee replacement um the knee re the arthritis in the knee isn’t life-threatening for you like reflux typically isn’t either it’s a lifestyle decision and if that knee is very uncomfortable for you to undergo replacement you’re going to feel much better for a longer period of time is that knee replacement going to last forever maybe not.”
Acidreflux.org.uk: “How does the recovery process work after the surgery?”
Dr Brown: ” That yeah the surgery takes about two hours and it’s done usually with an overnight stay in the hospital, traditionally it was done openly and the surgery has been around a long time it was originally described in by a surgeon named Nissan and it still bears his name a Nissan fundoplication and it used to be done openly with an incision in the upper abdomen back when I trained that’s how we did it then it’s transitioned to being done laparoscopically and that means with a small camera and generally four to five small incisions in the upper abdomen which makes recovery quicker the incision’s smaller pain are less and now I’ve transitioned into doing these robotically which has the advantage of those same small incisions but for me as a surgeon, the optics are superior the instrumentation is very precise and I think personally I’m able to do the surgery a little more uh efficiently and a little more quickly so hopefully it’ll be better for the patient right.”