Causes of Failed Reflux Surgery

Patients should be selected very carefully and should have a complete work-up prior to an antireflux procedure.

The majority of failed antireflux procedures are the result of inadequate patient selection, or incomplete diagnostic work-up prior to surgery and failure in surgical techniques.

The fundoplication (wrapping of the stomach around the esophagus) can be:

• too tight
• too lose
• twisted
• herniated into the chest
• slipped (the stomach is wrapped around itself instead of around the esophagus)

What is a Successful Antireflux Procedure?

Predictors of a successful antireflux procedure include:

• positive esophageal pH study (showing that there is acid inside the esophagus)
• the typical symptoms of reflux, such as heartburn and/or regurgitation
• response to medical therapy

What is a Complete Diagnostic Work-Up?

It is important to review the patient’s symptoms in detail, and to obtain a complete work-up in all patients who are candidate for antireflux surgery, including:

• videoesophagram
• esophageal pH assessment
• esophageal motility study
• upper endoscopy

Symptoms

After anti-reflux surgery, if a patient experiences recurrent symptoms (the same symptoms that were present prior to surgery), or new onset reflux-related symptoms, they should see their doctor.