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Nissen Fundoplication

Normally the opening between the esophagus and stomach acts like a one-way valve. This is called the Lower Esophageal Sphincter, or LES. It only opens when you swallow. Otherwise it is always tightly closed which prevent stomach acid from backsplashing up into your esophagus. When it fails to close properly, acid can backsplash, or "reflux" up into the esophagus. This can cause damage called GERD. GERD can be treated with medications. In severe cases, surgery is sometimes performed. The most common operation to treat GERD is Nissen Fundoplication. During this operation, the top part of the stomach organ is wrapped around the lower esophagus squeezing it slightly. This area of higher pressure helps keep the food and acid from backsplashing upward.

This short video clip was taken during a gastroscopy examination on a patient who has the Nissen operation five years ago. In this view, the gastroscope turned back upon itself so the doctor can visualize the top portion of the stomach. Note how the stomach is actually twisted around the lower esophagus. This patient has had no heartburn since the surgery and was able to stop his medications for GERD.

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Three Rivers Endoscopy Scope Cam

Nissen Fundoplication ("Wrap" procedure)

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