Chronic acid reflux, also known as gastroesophageal reflux disease (GERD), can cause heartburn when stomach acid moves back up into the esophagus.
GERD happens when a tiny valve at the end of your esophagus — which carries food from the mouth to the stomach — fails to close properly. Acidic leakage can cause that irritating cough and burning sensation in the throat.
For many people, drugstore remedies aren’t enough and the level of discomfort can be dramatic and seriously diminish quality of life.
A main cause of GERD is a hiatal hernia, where the upper stomach protrudes through the diaphragm and into the chest. Factors including pregnancy, obesity and smoking can also lead to developing GERD, which affects about 1 in 5 people in the U.S. and can be treated with simple surgery.
Robot-assisted surgery is a minimally invasive approach that uses advanced imaging technology to make smaller, more precise incisions. This procedure can mean less pain and risk of infection than open surgery.
“I’m a huge believer in robotic surgery,” said general surgeon Dr. Jefferson Tyler Watson of Novant Health General Surgery & Bariatrics - Mount Pleasant, who recently completed his 1,000th robotic procedure. “It delivers less pain, less need for narcotics, shorter hospital stays and faster recoveries.”
Watson walks through the advantages of the robotic approach to managing chronic acid reflux.
Nationally recognized surgical treatment close to home.
What damage can chronic acid reflux cause if it is left untreated?
The burning sensation can be pretty miserable, and some patients have it so bad that they regurgitate food. Some less common — but serious — symptoms include chronic pneumonia, if the reflux goes up and back down into the lungs. We also worry about chronic acid reflux increasing the risk of developing esophageal cancer.
What happens when medication isn’t effective at controlling acid reflux symptoms?
The goal of surgery is to create a valve to allow food to pass into the stomach while preventing acid from refluxing back into the esophagus. Another instance for surgical intervention is if a patient develops esophagitis (inflamed lining), which can lead to an increased risk of cancer.Robotic surgery is particularly advantageous when working up in the chest in a small space. In addition to using my own two hands, I'm working with three robotic arms which ensures precision.
And to be extra clear: We often think of robots doing work on their own. That’s not how robotically assisted surgery works. The surgeon is 100% in charge. The robot is just a complex tool that allows for smaller incisions that lead to less pain and quicker recovery.
I most often operate when a patient has a hiatal hernia. Robotic surgery allows me to get the stomach back down into the abdominal cavity in order to repair the hernia. I then perform laparoscopic Nissen fundoplication, which wraps the top of the stomach around the bottom of the esophagus. This creates a valve to stop the reflux.
What are the risks of surgery in this case?
It’s a major operation under general anesthesia, and there’s always a chance for serious complications under anesthesia. That said, the main complication we worry about with this procedure is the hernia coming back.
But the majority of patients I operate on are incredibly happy. They spend one night in the hospital, and their biggest postoperative hurdle is maintaining a liquid diet for several weeks while the new valve heals.
When should a person speak to a doctor about treatment for acid reflux?
Plenty of over-the-counter options treat mild acid reflux. But if it affects your everyday life, it’s certainly worth a conversation with your primary care physician. Don't be shy about asking for a referral to a gastroenterologist, who can use a camera to look inside the esophagus and stomach.
It’s always worth having a conversation to see if surgery can benefit you. We hope the procedure enables the patient to come off their reflux medication, and for the tissue to repair itself.
