Upper GI Surgery
Advanced laparoscopic surgical solutions for gastroesophageal reflux disease (GERD), hiatal hernia, and achalasia
Upper gastrointestinal surgery encompasses a range of advanced laparoscopic procedures designed to treat conditions affecting the esophagus, stomach, and upper digestive tract. Dr. Mahmoud Abdelwahab specializes in minimally invasive techniques that provide effective treatment with faster recovery times and reduced postoperative discomfort.
Our comprehensive upper GI surgery program includes treatment for gastroesophageal reflux disease (GERD), hiatal hernias, and achalasia.
Surgical Procedures & Explanations
Upper GI Procedures
Fundoplication is the gold standard surgical treatment for chronic gastroesophageal reflux disease (GERD) that doesn't respond to medical therapy. The procedure involves repair of the diaphragmatic crura and wrapping the upper portion of the stomach (fundus) around the lower esophagus to strengthen the lower esophageal sphincter and prevent acid reflux.
Indications:
- Chronic GERD unresponsive to medical management
- Large hiatal hernia with reflux symptoms
- Barrett's esophagus
- Respiratory complications from reflux (asthma, chronic cough)
Hiatal hernia occurs when part of the stomach protrudes through the diaphragm into the chest cavity. Laparoscopic hiatal hernia repair involves reducing the herniated stomach back into the abdomen, repairing the hiatal defect, and often performing a fundoplication to prevent reflux.
Indications:
- Symptomatic hiatal hernia with reflux or chest pain
- Paraesophageal hernia
- Cameron ulcers or bleeding from hiatal hernia
- Volvulus or incarceration risk
Achalasia is a rare disorder where the lower esophageal sphincter fails to relax properly, causing difficulty swallowing. Laparoscopic Heller myotomy involves cutting the muscle fibers of the lower esophageal sphincter to allow food to pass into the stomach, typically combined with a partial fundoplication to prevent reflux.
Indications:
- Confirmed achalasia on manometry
- Progressive dysphagia to solids and liquids
- Regurgitation and weight loss
- Failed or unsuitable for endoscopic treatment
Benefits of Laparoscopic Upper GI Surgery
Diagnostic Workup
- Upper endoscopy (EGD) to assess esophageal and stomach lining
- Barium swallow study to visualize anatomy and function
- Esophageal manometry to measure muscle contractions
- 24-hour pH monitoring for acid reflux quantification
- CT scan for anatomical assessment if needed
Pre-operative Optimization
- Optimization of acid suppression therapy
- Weight management if indicated
- Smoking cessation
- Fasting for 8-12 hours before surgery
Recovery Timeline
Hospital Stay
Most patients are discharged within 24-48 hours after laparoscopic procedures.
First Week
- Liquid diet for the first few days, then soft foods
- Avoid carbonated beverages and using straws
- Pain management with oral medications
- Walking to prevent blood clots
2-6 Weeks
- Gradual return to normal diet (avoid tough meats/breads initially)
- Return to work (desk jobs) within 1-2 weeks
- Avoid heavy lifting for 4-6 weeks
- Eat small, frequent meals
Long-term Follow-up
- Resolution of reflux symptoms
- Possible need for occasional acid suppression
- Monitoring for gas bloat syndrome (rare)
When to Seek Medical Attention
Contact your surgeon immediately if you experience:
- Difficulty swallowing liquids
- Persistent vomiting or retching
- Severe chest or abdominal pain
- Fever > 38°C
- Signs of wound infection
Find Relief Today
Schedule a consultation with Dr. Mahmoud Abdelwahab to discuss surgical options for your upper GI condition.
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