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what is laparoscopic anitireflux Surgery?

Antireflux Surgery (also known as Fundplication) is the standard surgical method of treating gastro-oesophageal reflux disease.

Reflux disease is the result of acid refluxing from the stomach backup into the oesophagus. This causes Inflammation and pain(heartburn).Normally there is a barrier to acid reflux. Part of this barrier is the lower-most muscle of the oesophagus (called the lower oesophageal sphincter). Most Of the time this muscle is contracted,which closes off the oesophagus from the stomach.

In patients with reflux disease,the sphincter does not function normally.The Muscle is either weak or relaxes in appropriately.

Fundoplication is a surgical technique that strengthens the barrier to acid reflux when the sphincter does not function normally.

Who needs Antireflux Surgery?

The vast majority of patients with reflux disease responds well to appropriate acid suppressing drugs and do not need surgery. However, for a small group of patients surgery can be helpful. There are three main reasons patients wish to have surgery:

1. Failure to respond satisfactorily to adequate doses of medication
2. Intolerable side effects from medication
3. A desire to free of long-term medication

What does surgery involve?

If the operation is being carried out for the first time, it is nearly always achieved using keyhole techniques (laparoscopic surgery). Compared to open surgery, which involves a larger incision, the laparoscopic method leads to a speedier recovery and less post operative pain.

The surgeon will make 3-4 small cuts in your abdomen and insert instruments to carry out the operation. A harmless gas (Carbon Dioxide) is used to inflate your abdomen to make space for the operation to be performed. This will disperse naturally after the operation.

Most patients have hiatus hernia associated with their reflux disease and repair of this hernia is undertaken at the same time as antireflux surgery. The hernia sac is pulled down from the chest and stitched so that it remains within the abdomen. Additionally the opening in the diaphragm, through which the oesophagus passes from chest into abdomen is tightened.

During the procedure the part of the stomach that is closet to the entry of the oesophagus (the fundus of stomach) is gathered, wrapped and stitched around the lower end of the oesophagus. This procedure increases the pressure at the lower end of the oesophagus and thereby reduces acid reflux. This wrap (or fundoplication) produces a kind of one-way valve from the stomach into the oesophagus that we call the procedure antireflux surgery. The operation usually takes between 1 and 11/2  hours

Anaesthesia

You will have a general Anaesthetic – this means you will be asleep though out the operation. More details about the anaesthesia will be given to you at your Pre-Opearative assessment visit and by the anaesthetist on the day of surgery.

How long will I stay in hospital?

You will normally stay in hospital for 2-3 days.

What are the possible complications?

All operations carry the risk of problems and side effects.

Specific risks connected to this  procedures  are:

• Injury to the oesophagus, Stomach, blood vessels and nearby organs. These complications are rare and the surgeon may convert to open surgery to repair any damage
• 1% of patients (1 in 100) may need further corrective surgery to reduce persistent difficulty m swallowing and/or abdominal bloating

Common side effects

• The most common side effect is difficulty in swallowing. This is common immediately after operation and gradually improves. The amount of food you consume may be less and you may have to eat more slowly than you did before the operation
• Other common side effects are burping and increased wind (flatus) Most of these symptom settle with timeAre there any alternatives?

  Antireflux surgery is the only treatment that can correct the anatomical abnormalities that lead to reflux. Surgery is generally recommended when other treatments have not been satisfactory. These include:

  Acid suppressing drugs (such as Omeprazole or Lansoprazole) to reduce acid reflux (these work by reducing or neutralizing the acid in the stomach or making the stomach empty faster) However to control your symptoms these may need to be taken regularly for the rest of your life

  Endoscopic techniques: These involve altering the oesophageal opening into the stomach through an endoscope. Currently these techniques are experimental and only performed as part of research trials

  Lifestyle changes such as losing weight, avoiding foods that contribute to acid reflux and stop smoking

How long does it take to fully recover after Antireflux surgery?

Most patients do not have pain as such after laparoscopic surgery, rather just some abdominal and chest discomfort, many patients do experience some degree of discomfort in their shoulders after the procedure. As the surgery has been performed laparoscopically you will need to stay in the hospital for only 2-3 days.

Because of the lack of any wound pain by the time you go home you may well think you are able to act as though you have not had an operation, neverthless you will find that you get tired easily and you may even wish to have a sleep in afternoon for a few days. We also ask the patients to avoid heavy lifting for at least 2-3 weeks.

You can return to work as soon as you feel well enough. This will depend on how you are feeling and the type of work that you do. Typically you will need two to three weeks off work.

You should not drive for at least 7-10 days after surgery.

what can I eat after surgery?

Stage 1 – Clear Liquid Diet

Immediately after 6 hours after surgery Avoid carbonated drinks for 3-4 weeks

Stage 2-Soft Diet:

• Start soft diet day after surgery, continue at this stage for 3 days after surgery or as tolerated
• Limit gas forming/irritating foods like coffee, alcohol, onions, fatty and oily foods, Raw vegetables etc
• Avoid breads, biscuit, pancakes and toast
• No carbonated drinks

Stage 3 – Transition to regular diet

• Start about 3 days after surgery • Soft diet as above
• Introduce more challenging foods one at a time
• If they cause symptoms avoid them and reintroduce them at a later date
• Drop back to stage 2 as needed for bloating or difficulty swallowing
• No carbonated drinks for 3-4 weeks (soft drinks)

Stage 4 – Regular Diet

Start 3 to 6 weeks after surgery

Further Information / Question

If you have any questions or concern about the information,

Please contact:

Surgery Reception – (02692) 288215

Dr. G. M. Mannari – 9825046137

Dr. Apurva Patel – 9825754862

Fever needs no introduction – it’s the most common of all ailments and something that all of us are familiar with.
At Iris Hospital, the best hospital in Anand, we have parents bringing in children with a high 100 degree fever, especially at this time of the year. It’s really heartbreaking to see the little ones suffer so much.
Fortunately, we have a team of the best general physicians in Anand, who are fully capable of handling any contingency, such as a seasonal outbreak of fever.
We do realize that that there is a lot of misinformation spread about fever. The purpose of this article is to inform and educate, so that you know exactly what to expect when you or a loved one is diagnosed with fever.

First, a word about ourselves…
IRIS hospital is a modern multi-specialty hospital located in the outskirts of Anand city. It gives us great pride to have some of the best doctors in Anand working for us.
It really helps that we are situated away from all the noise and the traffic of the city, which gives our patients the peace and tranquility they need. It’s no surprise that we are considered by many to be the best hospital in Anand.

So, what is Fever?
Fever is called by many names – controlled hyperthermia and pyrexia are some of the common medical terms used to describe fever. The symptoms of fever are a rise in body temperature beyond the normal 36–37° Centigrade (98–100° Fahrenheit).
The high body temperature experienced during fever is actually one of the ways the body fights back against infection. In fact, doctors would tell you that there is nothing wrong with having a mild fever.

When you have a slight fever, it shows that your immune system is working really hard to stop the onset of a more dangerous disease. Mild fever helps neutralize the virus or the bacteria that are causing the infectious disease.

The problem is when the fever becomes really severe, which means it goes beyond 38° Centigrade (100.4° Fahrenheit). In that case, the patient has to be monitored regularly and care must be taken that the fever does not go much beyond this. High fever is dangerous and can lead to delirium, depression and seizures.

Symptoms of Fever

The symptoms of fever are well known to most of us – you feel cold when nobody else does. You’re shivering and sweating all the time; have a pronounced lack of appetite and suffer from dehydration. You feel tired, exhausted and lethargic. You lack focus, want to sleep all the time and can’t get much work done when you have fever.

Causes of Fever

Fever is generally caused by infections such as flu, chickenpox, strep throat and pneumonia. It can also be caused by dehydration, heat and overexposure to the sun or heat stroke (which is very common here in Gujarat). Fever can also be caused by strenuous physical exercise.

Treatment for Fever

Antipyretics are medications used to bring down fever. Non-steroidal anti-inflammatory drugs (NSAIDs) such as Ibuprofen and Tylenol (paracetamol) can help bring down a mild fever.
But if the fever is severe, you should visit a general physician in Anand at the IRIS Hospital, who will prescribe a powerful antibiotic that will bring the fever down.
If your child has a fever, make sure that he or she drinks a lot of water. Dehydration is something that makes the fever worse. Complete rest is a must for those suffering from fever – no question of working when you are running a high temperature.
At IRIS Hopital, we have the very best Doctors in Anand. If you or a loved one is suffering from fever, book your appointment with one of our general physicians immediately. Don’t waste any time on that.