Acid Reflux – GERD FAQ and Full Guide 6 “When you do robotic and you know you have the incisions?  How do you know? I’m trying to guess imagine it is because you said you take kind of the stomach and the redundancy and kind of wrap it around that sphincter area there. How do you do that how does it manage to do that? Will you actually lift the stomach and turn it around with just the robotic hands and these incisions?

Dr Brown: “Exactly we create some space uh behind and around the oesophagus and again the stomach is floppy and loose enough and redundant enough that it’ll reach around behind and wrap around and then we just sew it back to itself, not unlike a pleat sort of and uh sew it back to itself and suture it back to itself and that holds it in place and it’s doing some of that suturing manoeuvring that’s uh much easier with the robot robotic”

What is the recovery time? “What’s the recovery time for someone like you said they might be in the hospital overnight but then what are they can they be back and active and walking and running in sports a week or two later?

Dr Brown: “Exactly within a week or two so I ask my patients to follow up in the office within one or two weeks and if they’re feeling good in terms of pain and discomfort and if they’re eating and swallowing well they can go about doing whatever they like”

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Can you start having acidic food after the surgery like coffee, alcohol etc? “You know prior to the surgery acid was backing up because they had some issues with that so maybe they were avoiding you know caffeine and alcohol and nicotine and some of those things which probably are not bad to avoid anyways from a health standpoint but after surgery could they go back and you know have caffeine maybe drink caffeine and coffee or something because now what was causing them problems.

Dr Brown: “Yes, ideally they should be able to sure they can go and enjoy their coffee or their glass of wine and hopefully not have the same symptoms same symptoms and most people who have the surgery better than %90 are able to stop their antacid medications completely.”

Can you have another surgery if the first one fails? “and then is it something that and I know you said you’re following patients years maybe years if they start feeling the reflux maybe that’s again the time they have to look to have maybe another procedure done possibly”

Dr Brown: “The surgery can fail there is a certain incidence of patients who just don’t respond to the surgery so that’s known I guess like any surgery but those are uncommon there can certainly be some technical failures of the surgery that arise and that would require some additional testing and possibly a revision surgery but generally with time if someone’s symptoms are just starting to creep in again a little bit here and there then they might need to take an anti-acid from time to time.

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Is acid reflux common among old people? ” Do you see your patients would they be older now can I just kind of imagine you know unfortunately as we get older the body starts you know losing some of its strength and some of the things happen we start breaking down more so is this something where more of your surgeries are in older patients?”

Dr Brown: “ I’ve seen a lot of different variety of patients so the thing that I do see in older patients with Hiatal hernias more and a hiatal hernia is something which is commonly associated with reflux but isn’t necessarily causative of the reflux itself and it can be seen with the scope they look in the stomach and see a hiatal hernia and what that is is it’s a little hole or widening of the diaphragm muscle that separates the chest from the abdomen and the oesophagus has to pass through that muscle to get into the abdomen to the stomach and if that muscle starts to widen then the stomach can actually slip up into the chest when that happens to a small extent it’s not a big deal it’s very common and it frequently happens with age as that hole gets big enough actually the entire stomach can herniate into the chest and cause significant symptoms which might mimic reflux in some patients so that’s the sort of thing that I see in older patients”

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Dr Brown: ”It’s fixed in a very similar way we just pull the stomach back down where it belongs basically we do the anti-reflux wrap and then we also use sutures to close up that hole in the diaphragm at the same time.” “And a hiatal hernia is that just based because of age it’s our age and that some things start happening or is it or is it because of reflux a little bit of both that causes it?

Dr Brown: “Typically age is a thing like Hiatal hernias I equate them a little bit to like grey hairs you know if you get old enough you’re going to get some grey hairs and you’re going to get a little bit of a hiatal hernia and in most cases it’s inconsequential.”

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