Gastro-oesophageal reflux

Gastro-oesophageal reflux disease is a common reason for children to undergo major abdominal surgery. The operation is called fundoplication and is usually performed with keyhole surgery.

The stomach produces a strong acid, which is kept away from the oesophagus, or gullet, by a high pressure area at the end of the oesophagus.

Gastro-oesophageal reflux occurs when the high pressure area fails for a variety of reasons.

As most children spontaneously grow out of their reflux, there is a strong argument to attempt to treat reflux with drugs initially, reserving surgery for cases which do not resolve.

When fundoplication was performed using open surgery the procedure was a major challenge for children, with a lot of pain afterwards. Now we utilise keyhole surgery, there is less pain and the procedure is much better tolerated.

An interesting feature of the operation in children is how frequently the fundoplication comes undone. I believe this is due to the growth of the child and is therefore unavoidable. However, it does mean that many children require the operation to be re-done, and this is a particular interest of mine. There is a link at the bottom of this page to my results for revisional fundoplications.