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Nissen Fundoplication is used to treat severe Gastro-oesophageal Reflux Disease (GERD) when medications fail to provide adequate relief. It works by wrapping the fundus (upper part of the stomach) around the lower oesophagus to strengthen the anti-reflux barrier between the stomach and oesophagus. Large hiatal hernias, medication-resistant persistent GERD, and reflux-related problems such oesophagitis (inflammation), Barrett's oesophagus (in certain cases), oesophageal strictures (narrowing), and reflux-related chronic cough or recurrent aspiration are frequently advised.
Consult your doctor if you have severe heartburn despite long-term medication use, regurgitation of food or acid, dysphagia (difficulty swallowing), persistent cough or worsening asthma due to reflux, reflux-related chest pain after cardiac causes are ruled out, frequent hoarseness or throat discomfort, and complications such as reflux ulcers or Barrett's oesophagus.
Prior to surgery, patients undergo a clinical assessment and medical history review, followed by investigations such as upper gastrointestinal endoscopy, 24-hour pH monitoring, oesophageal manometry, and barium swallow study in select cases, as well as routine tests such as LFT, RFT, CBC, chest X-ray, and ECG. Before surgery, patients are recommended to abstain from alcohol and tobacco, stop taking blood thinners (if prescribed), and fast for six to eight hours.
Nissen fundoplication is typically carried out laparoscopically under general anaesthesia. The surgeon makes tiny keyhole incisions, repairs any hiatal hernia, and then completely wraps the fundus (upper portion of the stomach) around the lower oesophagus to strengthen the anti-reflux barrier. The incisions are closed while the patient is monitored, and the wrap is secured to prevent reflux.
Usually, the procedure takes one to two hours. The duration of surgery can also differ based on the patient's anatomy, past abdominal procedures, and the existence of comorbidities.
Nissen fundoplication is safe, but there are a few potential risks:
- Infection and bleeding
- Initial difficulty swallowing (temporary dysphagia)
- Gas-bloat syndrome (increased bloating, trouble belching)
- Vomiting or nausea
- Failure or loosening of the wrap (rare)
- Symptoms of reflux returning
- Damage to the spleen, oesophagus, or stomach (rare)
- Risks associated with anaesthesia
Fundoplication provides multiple benefits, including long-term relief of GERD symptoms, a reduction in the requirement for long-term acid-suppressive drugs, increased quality of life, prevention of reflux-related oesophageal injury, and better control of aspiration symptoms and persistent cough.
Postoperative recovery usually comprises a one to three-day hospital stay, as well as breathing exercises and early walking to aid with recuperation. Over the course of several weeks, a structured dietary progression is followed, progressing from liquids to a soft diet and finally to a regular diet.
Nissen fundoplication has a high success rate; 85–95% of patients attain symptom control, and in carefully selected situations, the long-term results are outstanding. Overall outcomes are mostly determined by the surgeon's experience and skill as well as a thorough pre-surgical assessment.
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Bayindir Healthcare Group
Ankara, Turkey
Bayindir Healthcare Group located in Ankara, Turkey is accredited by ISO, JCI. Also listed below are some of the most prominent infrastructural details:
- Bayindir Healthcare Group comprises 3 hospitals, 6 Dental special clinics and 1 Medical Center.
- Sogutozu Hospital
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- Kavaklidere Hospital
- Levent Medical Center
- Fenerbahce Dental Clinic
- Besiktas Dental Clinic
- Icerenkoy Dental Clinic
- Is Tower Dental Clinic
- Sirinevler Dental Clinic
- Alsancak Dental Clinic
- The International Patient Center was set up in 2010. It is a resource for doctors and the available healthcare services, arranging for consultations and appointments. Also, it manages the travel, transfer, accommodation, visa and insurance resources and translation for international medical travellers.
- Networking with physicians from various countries to ensure knowledge and know how growth and implementation work towards the benefit of patients.
Medicana Sivas Hospital
Sivas, Turkey
Medicana Sivas Hospital located in Sivas, Turkey is accredited by ISO, JCI. Also listed below are some of the most prominent infrastructural details:
- 24/7 Emergency Department
- 28.000 m2 Closed Area
- Capacity of 219 beds
- 7 Operating rooms
- 49 intensive care beds
- 15 newborn intensive care beds
- 5 Cardiovascular intensive care beds
- 4 coronary intensive care beds
- 28 observation beds
- It has started to serve with a capacity of 15 beds in the newborn intensive care unit with the investment of physicians and devices it has made, recently
- Hospitality services include- Standard and Suite rooms, fully-equipped with TV, Air conditioning system at room level, hairdresser, dialysis services, cafeteria, Place of worship, etc.
- Car Parking with a capacity of 75 vehicles
- The hospital cafeteria provides both cafe and food service in the hospital
Max Super Speciality Hospital, Saket
Delhi, India
Max Smart Super Speciality Hospital, Saket, is a 250-bed tertiary care hospital awarded NABH accreditation, which provides advanced medical care in various specialities such as Cardiac Sciences, Orthopaedics, Neurology, Urology, Kidney Transplant, Paediatrics, and Obstetrics & Gynaecology. The hospital provides quality, safe, integrated, and patient-centric medical care using modular OTs, ICUs, Cath Labs, CT, MRI and Dialysis units.
Manipal Hospital, Hebbal
Bangalore, India
Manipal Hospitals, a group of Manipal Education Medical Group, is India’s leading multi-speciality network, comprising over 650 beds. Dedicated to clinical excellence, patient-centric care and ethical practices, it provides sophisticated diagnostics, surgery and home care services to both domestic and international patients, while also improving access to affordable healthcare for underprivileged communities.
Clear Medi Hospital, Karkardooma
Delhi, India
Clear Medi Hospital, Karkardooma located in New Delhi, India is accredited by ISO. Also listed below are some of the most prominent infrastructural details:
- There are 12 Linear Accelerators in all hospitals of Clear Medi Hospital, Delhi, India and more in the development stage.
- Over 25 surgical and medical specialties across all Clear Medi Hospitals
- Care Medi is one of the biggest Oncology care organisations in India.
- Hospital management solutions provided to over 15 partner healthcare organisations managing more than 300 beds.
- The organisation consists of offerings such as clinical manpower management and equipment management.
- Advanced radiology and nuclear medicine centres
- Professionally managed international patient care
- Clear Medi Hospital, Delhi has a capacity of 100 beds.
- Clear Medi is a multispecialty hospital.
- It is a NABH (National Accreditation Board for Hospitals & Healthcare providers) certified hospital.
- It has Oncology and Cardiac departments with an Intensive Care Unit.
- It also has fully equipped Operation Theatres.
- Clear Medi Hospital ensures coordination with patients and International Patient assistance
- It has an online Tumor Board with a number of Medical, Surgical and Radiation Oncologists.
Herzliya Medical Center
Herzliya, Israel
Apart from in-detail treatment procedures available, Herzliya Medical Center located in Herzliya, Israel has a wide variety of facilities available for International Patients. Some of the facilities which are provided by them are Accommodation, Airport Transfer, Interpreter, SIM, TV inside room. Also listed below are some of the most prominent infrastructural details:
- 350+ leading doctors in senior positions working with the Hospital
- Single & Double Standard Rooms
- VIP Suites and Decor rooms
- 20 Departments
- 19 Outpatient Clinics
- 12 Institutes
- 4 hospitalization Offices
- 7 Operating rooms
- 2 Pharmacies
- 12 VIP chambers
- IVF Centre
- Top specialties offered by the Hospital are- Hysterography, Eye Microsurgery, Ablation, Amniocentesis, Angiography, Ankylosing Spondylitis, Aorta Surgery, Arthroplasthy, Bone Marrow Biopsy, Brain Tumor Surgery, Breast Cancer, Breast Lift, etc.
Sheba Medical Center
Ramat Gan, Israel
Sheba Medical Center located in Tel-Hashomer, Israel is accredited by JCI. Also listed below are some of the most prominent infrastructural details:
- Sheba Medical Center has a 1900 bed capacity.
- It also consists of as many as 120 departments and clinics.
- Sheba treats a large number of national and international patients from many Asian and European countries among others.
- International patient care services in Sheba are very strong, this also includes the travel, stay, transfer related coordination with translator services.
- The healthcare personnel working in Sheba Medical Center are fluent in English, documents are also available in this common denominator language.
- Rehabilitation services are available for long term recovery and return back to a normal life and activity. This could include conditions related to Orthopedics, Neurology, psychiatry, old age and injuries etc.
Acibadem Altunizade Hospital
Istanbul, Turkey
Acibadem Altunizade Hospital located in Istanbul, Turkey is accredited by JCI. Also listed below are some of the most prominent infrastructural details:
- The indoor area of Acibadem Hastanesi - Altunizade, Istanbul, Turkey is one of the largest at 98,000 square meters.
- There are 550 beds and as many parking spots.
- 75 of the beds are in the intensive care unit.
- A hybrid operating room which has 3 diagnostic units at one location which is an amazing concept as at one time surgeries can be performed in 3 operating theatres.
- International patients are serviced well through a particular center for them where services related to therapy and diagnostics are done.
- Healthcare delivery in this part of the hospital can be availed in 16 different languages.
- Robotic Surgery and Cell Therapy Unit are representative of the high standards of technology present in the hospital.
VPS Rockland Hospital
Gurgaon, India
VPS Rockland Hospital located in Gurugram, India is accredited by NABH, NABL. Also listed below are some of the most prominent infrastructural details:
- Well-designed compact 103-bed hospital expanding over120,000 square feet
- Well equipped modular operation theatres, intensive care unit, interventional Cath lab, and in-patient rooms ranging from economy to luxury
- Offers a bouquet of services like Internal Medicine, Obstetrics & Gynaecology, Surgery, Pediatrics
- High-end diagnostic services like 1.5 T MRI and 128 slice CT Scan
- Advanced non-invasive assessment with echo & TMT machines
- State of the art cardiac Cath-Lab
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- Accommodation arrangement for the accompanying attendant
- Customized diet for patient and attendant
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- Registration with the Foreigners Regional Registration Office
- Dedicated Neuro-Intensive care unit managed by expert intensivists
- Accommodation arrangements post discharge
- Highly advanced instruments for deep brain stimulation, stereotaxy, micro-neurosurgery, pediatric neurosurgery & neurophysiology
- Most advanced dialysis machines and advanced diagnostic and therapeutic facilities
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- Technologically advanced endoscopy suite
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- Dialysis beds
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- Deployed high-end technologies & smart digital system
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Acibadem University Hospital Atakent
Istanbul, Turkey
Acibadem University Hospital Atakent located in Istanbul, Turkey is accredited by JCI. Also listed below are some of the most prominent infrastructural details:
- Spread over an area of 60,000 square meters
- It has 300 wards with 8 operating rooms
- It has an inpatient treatment capacity of 278
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- The healthcare organisation has several kinds of infrastructure for services such as free parking, cafeteria, Wi-Fi, hairdressing salon, ATM, ergonomic hospital beds, and prayer rooms.
- The hospital has both standard single rooms and double rooms (24 in number) for the patients.
- The hospital wards are also equipped with metal handrails, emergency cords, and call buttons for patients with mobility issues.
- The latest medical technology is present here to treat patients such as MR-LINAC linear accelerator, The da Vinci robot, and TrueBeam Linear Accelerator.
- The diagnostic department of the hospital has the following equipments:
- MRI 3 Tesla
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+99Process Involved for Nissen Fundoplication
- GERD diagnosis and severity assessment
- Testing prior to surgery (manometry, pH monitoring, endoscope)
- Planning for surgery
- Method (fundoplication ± correction of a hiatal hernia)
- Recuperation after surgery and diet advancement
- Monitoring to manage reflux symptoms
- Severe GERD
- Reflux with hiatal hernia
- Esophageal reflux
- Barrett's oesophagus (in certain instances)
- Aspiration or coughing due to reflux
- Laparoscopic Nissen Fundoplication (the most common).
- Nissen Fundoplication is open.
- Fundoplication with robotic assistance
- In certain situations, partial fundoplication (Toupet/Dor)
In {country}, for medical treatment:
- Verifiable proof of identity (passport or visa for foreign patients)
- Diagnostic reports (manometry, pH analysis, endoscopy)
- Consent forms for anaesthesia and surgery
- Documentation related to insurance (if appropriate)
Patients may be eligible if:
- Despite taking medication, GERD symptoms continue.
- The patient has Barrett's changes, strictures, and oesophagitis as reflux consequences.
- There is a large hiatal hernia.
- The patient would rather have surgery than take medication for life.
- The patient is ready for surgery and anaesthesia.
- Hiatal hernia repair
- Endoscopy (follow-up and diagnostic)
- Dilatation of the oesophagus (if stricture is present)
- Long-term or permanent management of reflux
- Oesophagitis healing
- Decreased long-term GERD complications
- Reduced reliance on acid suppressants
After a successful fundoplication
- Regurgitation and heartburn considerably lessen
- Reflux lessens at night.
- After the initial recuperation, swallowing gradually gets better.
- Better quality of life and sleep
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