Laparoscopic Anti-Reflux Surgery in Mérida

Dra. Montserrat Monroy · Board-Certified Surgeon (CMCG)
Last medical review: September 2026

What Is Gastroesophageal Reflux Disease?

Gastroesophageal reflux disease (GERD) is a chronic condition in which stomach acid frequently flows back into the esophagus, causing symptoms such as heartburn, acid regurgitation, chest pain, difficulty swallowing, chronic cough, and hoarseness. Over time, uncontrolled reflux can cause esophageal inflammation (esophagitis), ulcers, strictures (narrowing), and in severe cases, Barrett's esophagus, a precancerous condition.

Most patients with reflux respond well to medical treatment with proton pump inhibitors (omeprazole, pantoprazole, esomeprazole). However, when symptoms persist despite treatment, when the patient requires lifelong medication with side effects, or when there are complications such as a large hiatal hernia, anti-reflux surgery offers a definitive solution.

Dr. Monroy performs anti-reflux surgery laparoscopically, restoring the natural barrier against reflux through a technique called fundoplication.

When Is Anti-Reflux Surgery Recommended?

Surgery is considered when medical treatment fails to adequately control the disease:

• Medication-refractory reflux: symptoms that persist despite optimal treatment with proton pump inhibitors at adequate doses for a sufficient period.
• Chronic medication dependence: patients who require indefinite anti-reflux medication and prefer a definitive surgical solution.
• Significant hiatal hernia: when a sizeable hiatal hernia contributes to reflux, surgical hernia repair is combined with fundoplication.
• Extra-esophageal symptoms: chronic cough, difficult-to-control asthma, laryngitis, or dental erosions caused by acid reflux that do not improve with medication.
• Reflux complications: severe esophagitis, peptic stricture, or Barrett's esophagus requiring intervention beyond pharmacological treatment.

Before surgery, specialized studies such as endoscopy, esophageal manometry, and 24-hour pH monitoring are performed to confirm the diagnosis and ensure surgery is the best option.

How Is Laparoscopic Fundoplication Performed?

Fundoplication is the standard procedure for anti-reflux surgery. It is performed laparoscopically under general anesthesia:

1. Laparoscopic access: 4 to 5 small incisions are made in the upper abdomen. The camera and surgical instruments are introduced.
2. Hiatal hernia repair: if a hiatal hernia is present, it is repaired first by closing the diaphragmatic defect with sutures (and mesh in selected cases).
3. Fundoplication: the upper part of the stomach (fundus) is wrapped around the lower portion of the esophagus, creating a valve that prevents acid from flowing back. The most commonly used technique is the Nissen fundoplication (complete 360° wrap), though in specific cases, partial variants (Toupet, Dor) may be used.
4. Verification and closure: the function of the new valve is verified and incisions are closed.

The procedure takes approximately 1 to 2 hours. The choice of specific fundoplication technique depends on esophageal manometry results and the clinical evaluation of each patient.

Recovery After Anti-Reflux Surgery

Recovery is progressive and requires temporary dietary modifications:

• Hospital stay of 1 to 2 nights.
• Liquid diet during the first 1 to 2 weeks, followed by soft foods for 2 to 4 more weeks before resuming a regular diet.
• Temporary difficulty swallowing (mild dysphagia) during the first weeks, which resolves progressively as inflammation decreases.
• Return to daily activities within 1 to 2 weeks.
• Avoid intense physical exertion for 4 to 6 weeks.

Most patients can discontinue anti-reflux medications after surgery, under medical supervision. Dr. Monroy provides a detailed dietary plan for each stage of recovery.

Anti-Reflux Surgery Results

Laparoscopic fundoplication has a high success rate in controlling gastroesophageal reflux:

• The vast majority of patients experience significant or complete relief from reflux symptoms.
• Most achieve discontinuation of anti-reflux medications.
• Results are generally durable long-term.
• Patient satisfaction is generally high.

Results depend on proper patient selection, complete preoperative studies, and the surgeon's experience. Dr. Monroy establishes realistic expectations during the evaluation consultation.

Is anti-reflux surgery permanent?

Fundoplication produces anatomical changes designed to be permanent. Most patients maintain excellent long-term reflux control. A small percentage of patients may experience symptom recurrence over time, which may require supplementary medication or, in exceptional cases, revision surgery.

Can I burp and vomit after surgery?

Fundoplication creates a valve that makes it difficult for stomach contents to flow back. Some patients experience temporary difficulty belching, bloating sensation, or inability to vomit, especially during the first weeks. These effects generally diminish over time. The choice of fundoplication technique (total or partial) can be adjusted based on each patient's characteristics to minimize these effects.