Postoperative Course
The procedure is performed on the day of hospital admission. The hospital stay typically lasts two nights.
Careful mobilization begins within a few hours after surgery. Early ambulation supports pulmonary function, stabilizes the circulation, and promotes bowel activity.
During the first few days, a mild pressure sensation behind the breastbone as well as occasional shoulder pain—most commonly on the left side—may occur.
The pressure sensation reflects the surgical intervention at the level of the gastroesophageal junction and temporary tissue swelling.
The shoulder pain is caused by the carbon dioxide used during laparoscopy to create the necessary working space. Despite careful removal, a small residual amount may temporarily cause discomfort.
Both symptoms are harmless, easily manageable, and usually resolve within a few days.
Transient swallowing difficulties may occur in rare cases. Strict adherence to dietary recommendations further reduces this risk. Structured nutritional counseling is provided prior to surgery and during the first postoperative days. In addition, you will receive written dietary guidelines for the initial weeks.
During the early postoperative phase, several small meals per day, slow eating, and thorough chewing are essential. Gas-producing, highly fibrous, very hot, or strongly spiced foods should initially be avoided. Carbonated beverages should be avoided or consumed only after being degassed. Alcohol should be consumed only in very small amounts during the first weeks.
During the first eight weeks, no loads over 5 to 7 kg should be lifted. More intensive physical activity is usually possible after approximately eight weeks, and strength training after about three months. Contact sports or extreme physical strain should be avoided for approximately six months.
Patients who were taking proton pump inhibitors (PPIs) prior to surgery should continue this medication during their hospital stay. Thereafter, a rapid but controlled tapering is performed.
Healing is a biological process that requires time. During the first six to eight weeks, any unnecessary increase in intra-abdominal pressure should be avoided, in particular straining. To prevent constipation, stool-regulating medication will be prescribed if necessary.
The information provided here does not replace the personal preoperative consultation. All individual aspects and any remaining questions will be discussed in detail prior to surgery.
Frequently Asked Questions
Do I need to continue taking reflux medication after surgery?
Following successful surgical restoration of the anatomical conditions, long-term use of acid-suppressing medication is generally no longer required.
Will I still be able to belch or vomit after surgery?
A key objective of the surgical technique is to preserve the natural function of the gastroesophageal junction. In the vast majority of cases, both the ability to belch and the ability to vomit are preserved.
Is the procedure durable, or can reflux recur?
In most cases, surgical treatment results in sustained symptom relief. Recurrence of reflux symptoms is possible in principle but overall very rare.
What are the risks associated with the procedure?
As with any surgical intervention, general risks such as bleeding, infection, or injury to adjacent structures exist. The procedure itself is well established and associated with an overall very low complication rate.
Who is a suitable candidate for surgical treatment of reflux disease?
Surgical treatment may be particularly appropriate for patients in whom conservative and medical therapies are insufficiently effective, not well tolerated, or when there is a desire to avoid long-term medication.
Patients with mechanically induced reflux of gastric contents or acid extending into the upper chest, throat, or mouth—particularly when lying down—tend to benefit most. In these cases, surgical restoration of the anatomical and physiological conditions may result in complete symptom resolution.
How is the procedure performed, and how long is the recovery in the hospital?
The procedure is performed using a minimally invasive approach. The hospital stay typically lasts two nights. Recovery continues gradually over several weeks, during which physical exertion should be temporarily limited.
What diagnostic evaluation is required prior to surgery?
A thorough preoperative evaluation is essential. This includes a detailed medical history and physical examination.
Upper endoscopy (gastroscopy) and assessment of esophageal motility using high-resolution esophageal manometry are mandatory.
Depending on the findings, additional testing may include measurement of acid exposure, either by 24-hour impedance-pH monitoring or by a 48-hour pH study using a BRAVO capsule.
In selected cases, contrast radiography of the esophagus and the gastroesophageal junction may be performed. Further diagnostic tests are guided by the individual clinical situation.
Do you have any questions? Contact us.
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