What Is The Medical Term For Surgical Repair Of The Stomach?

Gastroesophageal Reflux Repair or Wrap Surgery

At UPMC Children'due south Hospital of Pittsburgh, nosotros believe parents and guardians can contribute to the success of this surgery and invite yous to participate. Please read the following information to learn about the surgery and how you tin help.

Fast Facts About the "Wrap" Surgery

The gastroesophogeal reflux repair or "wrap" surgery corrects Gastroesophogeal Reflux Disease (GERD). GERD is a digestive disorder that causes acids in the tummy to menses support into the esophagus, the "foodpipe" or swallowing tube that carries food from the mouth to the tum.
Your kid'due south surgery volition have place at Children's Hospital in Lawrenceville.
Your kid's surgery will be done under general anesthesia, which ways that he or she will be sound asleep during the surgery.
When general anesthesia is needed, there are special rules for eating and drinking that must be followed in the hours before surgery.
There are two techniques for the repair surgery:

The laparoscopic technique, in which the surgeon makes small incisions (cuts) in the skin and inserts tiny scopes or cameras to run across within the body while doing the repair. This surgical technique is used most often for wrap surgeries done at Children's.
The traditional "open" technique, in which the surgeon makes a big incision to give a full view of the areas involved in the repair surgery.

The surgery takes between ane and 2 hours.
The infirmary stay is typically ii to iv days if done laparoscopically or most one week for the open method.

What Is Gastroesophogeal Reflux Repair?

Gastroesophageal Reflux Repair or Wrap Surgery

Normally, breadbasket contents and acid are stopped from coming back up into the esophagus (es-SOF-uh-gus) past a muscle at the bottom of the esophagus. When this muscle doesn't work properly, the contents of the tummy flow dorsum into the esophagus. The backward flow is chosen "reflux."

If uncorrected, the acid can harm the lining of the esophagus by causing ulcers, scars or bleeding. The stomach contents also can come up the esophagus and enter the lungs. This is called "aspiration" (as-per-A-shun) and can cause coughing, airway irritation or fifty-fifty pneumonia.

In nearly cases, reflux tin can exist treated with medication taken by mouth; only for those children whose symptoms have non improved with medication, surgery is recommended.
The gastroesophogeal (GAS-tro-ee-sof-uh-JEE-ul) repair surgery is oftentimes referred to equally a "wrap" considering the upper portion of the tum is wrapped around the lower portion of the esophagus. The wrap tightens or narrows the opening of the esophagus every bit it enters into the stomach. Later on the surgery, the wrap keeps food and fluids from backing up into the esophagus from the breadbasket.

This surgery is washed under full general anesthesia. General anesthesia makes your kid's whole trunk become to sleep and is needed for this surgery then that his or her reflexes volition be completely relaxed. General anesthesia makes the surgery easier and safer to exercise because your kid will not feel any pain or have whatsoever memory of the surgery.

Tests Needed Before Surgery

Once the conclusion for surgical treatment is made, your doctor may need your kid to have a few tests to make sure that the surgery is correct for your child. Your child's dr. may lodge:

An upper GI study to look at the GI (gastrointestinal) tract to examine the esophagus, breadbasket and office of the pocket-sized intestine.
A gastric emptying exam to see how quickly a meal clears from the stomach.
A pH probe study to measure the acidity in the esophagus.
An esophageal biopsy to confirm continued acid reflux.

These tests are done through the Gastroenterology Section at Children's.

The Surgery

Once your child has been registered, he or she will be taken to a "holding area" where you will meet the anesthesiologist and your surgeon. A pediatric anesthesiologist—a doc who specializes in anesthesia for children—will give the medications that will make your child slumber during the surgery. At this time, you lot will be able to ask whatsoever questions near the procedure.

Once questions are answered and the operating room is prepared, your kid will exist taken into the operating room and given an coldhearted to make him or her go to sleep.
When your child is comatose, the surgery will begin. If using the laparoscopic (lap-a-ro-SKOPP-ic) technique:

The surgeon will use small instruments to work through 4 or five modest incisions (cuts) in the skin in the abdomen or tummy.
A small camera will be inserted through another pocket-sized incision.
The surgeon will fill the abdomen with gas to inflate information technology to create a working space and help him or her come across more hands during the surgery.
Once the procedure is done, the surgeon volition close the incisions with sutures (SOO-chers) or stitches that dissolve on their own.

If the surgery is done using an "open up" process, an incision is made in the upper abdomen.

In both techniques, the upper part of the stomach is wrapped effectually the lowest part of the esophagus and placed into position using dissolvable sutures.
The "wrap" of stomach tissue increases pressure on the muscle at the lesser of the esophagus, keeping tum contents and acrid from going back into the esophagus.
Your surgeon also will decide whether or not a gastrostomy (gas-STROSS-te-mee) tube will be used during the surgery. The gastrostomy tube is inserted through an incision to assist "burp" air from the stomach and also may be used for feedings in infants and children.

Dwelling house Preparation

When general anesthesia is needed, there are of import rules for eating and drinking that must be followed in the hours before the surgery. One concern day before your child's surgery, you volition receive a phone call from a nurse between the hours of 1 and 9 p.thousand. (Nurses do not brand these calls on weekends or holidays.) Please have paper and a pen ready to write downwardly these of import instructions.

The nurse will give y'all specific eating and drinking instructions for your child based on your child'due south historic period. Following are the usual instructions given for eating and drinking. No matter what age your kid is, you lot should follow the specific instructions given to you on the phone by the nurse.

For children older than 12 months:

Afterwards midnight the night before the surgery, do not give any solid food or non-clear liquids. That includes milk, formula, juices with pulp, coffee and chewing gum or candy.

For infants under 12 months:

Up to 6 hours earlier the scheduled arrival time, formula-fed babies may be given formula.
Up to 4 hours before the scheduled arrival time, breastfed babies may nurse.

For all children:

Upwards to two hours before the scheduled arrival fourth dimension, give only clear liquids. Clear liquids include water, Pedialyte®, Kool-Aid® and juices you can see through, such as apple or white grape juice.
In the 2 hours earlier the scheduled arrival fourth dimension, requite zero to swallow or drink.

Going to Sleep

Earlier the surgery, a member of the anesthesia staff volition meet with you to take your child'south vital signs, weight and medical history. Equally the parent or legal guardian, yous will be asked to sign a consent grade before the anesthesia is given.

The anesthesiologist will meet with you and your child to review your child's medical information and decide which kind of sleep medication your child should go.
If your kid is very scared or upset, the doctor may give a special medication to help him or her relax. This medication is flavored and takes issue in ten to xv minutes.
If you wish, you may go with your kid to the room where the surgery will be washed and stay as the sleep medication is given.
Younger children will get their sleep medication through a "space mask" that will conduct air mixed with medication. Your kid may choose a favorite scent to flavour the air flowing through the mask. There are no shots or needles used while your child is still awake.
Older children may choose betwixt getting their medication through the mask or directly into a vein through an intravenous (IV) line.
When your child has fallen asleep, you will be taken to the waiting room. If information technology has not already been washed, an IV will be started and then that medication tin can be given to proceed your child sleeping throughout the surgery.

While Asleep

While your child is asleep, his or her centre rate, blood pressure, temperature and claret oxygen level will be checked continuously.

Your child might accept a breathing tube placed while he or she is asleep. If a breathing tube is used, your child might have a sore pharynx after the surgery.
To keep your child asleep during the surgery, he or she might be given anesthetic medication by mask, through the Iv tube or both. When the surgery is over, the medications will exist stopped and your child will begin to wake up.

Waking Up

Gastroesophageal Reflux Repair or Wrap Surgery

When your child is moved to the recovery room, you will be called and so that you can be in that location as he or she wakes up.

Your kid will demand to stay in the recovery room to be watched until he or she is alarm and his or her vital signs are stable. The length of time your child will spend in the recovery room volition vary because some children take longer than others to wake up subsequently anesthesia.
Children coming out of anesthesia react in different means. Your child might weep, be fussy or confused, feel ill to his or her stomach, or vomit. These reactions are normal and will become abroad as the anesthesia wears off.
While your child is in recovery, your surgeon will talk to you lot near the surgery. That is a skillful time to inquire questions nearly pain medication, diet and activity.

A Parent's/Guardian's Role During the Surgery

The most important role of a parent or guardian is to help your child stay calm and relaxed earlier the surgery. The best way to assist your child stay calm is for you to stay calm.

Yous are encouraged to talk to your child or concur his hand before the surgery, while slumber medication is given and while in recovery.
Y'all may bring along a "condolement" item—such as a favorite blimp animal or "blankie"—for your child to agree before and after the surgery

After the Surgery

Your child will have an IV for getting hurting medication for as long equally he or she needs information technology after the surgery (usually most 1 twenty-four hour period for the laparoscopic procedure and two to 3 days for the open up procedure). Later on this fourth dimension, your child will be prescribed a pain medication to be taken by mouth.

While in the hospital, your child volition be encouraged to get out of bed past the adjacent solar day.

At Home After the Surgery

Gastroesophageal Reflux Repair or Wrap Surgery If your child had the laparoscopic procedure, he or she will have Steri-StripsTM covering the minor incisions. Steri-Strips are adhesive strips that are sometimes used on shallow cuts instead of stitches to hold the edges of the cutting together. They volition dry up and fall off on their own as the incision heals.

If your child had an open up process, he or she may have Steri-Strips covered by a gauze bandage or dressing over the incision. This dressing will be changed during your child'due south hospital stay. You will be given instructions on how to care for the dressing when your kid leaves the hospital. The Steri-Strips will autumn off on their own every bit the incision heals.

If your child comes home with a gastrostomy tube, you will be given instructions on how to care for it before leaving the infirmary.

Later the surgery, at that place will exist a balmy swelling of the wrap while the surgery heals. This swelling should get down within ii weeks. Your child should have mostly liquids for the first 2 weeks after surgery.

Liquids may be clear (such every bit Popsicles®, Gatorade® and h2o) or unclear (such as ice cream, milk and soup).
Solids may be introduced slowly during this time.

Gastroesophageal Reflux Repair or Wrap Surgery Your kid also should avoid eating certain foods.

Carbonated beverages should be avoided for several weeks and maybe for the rest of your child'southward life. You may slowly innovate pocket-size amounts of soda into your child'due south diet when he or she is feeling better to meet if it can be tolerated.
Corn, beans, peas, onions, broccoli, cauliflower, lycopersicon esculentum products and citrus fruits should be avoided.
No chocolate or peppermint.
Avoid pepper and coarse cereals with bran.
Foods that may go lodged in the expanse of the "wrap," such at hot dogs, French fries, dry chicken or wadded-up bread should be avoided. If your child does consume these foods, they should be well chewed or cut into very small pieces.

Later on the laparoscopic process, your kid may go back to normal action in about 1 to 2 weeks. After an open up procedure, your child may go dorsum to normal action in about 2 to 3 weeks. At this time, your kid may return to school. He or she may get back to gym class later on the follow-up visit with your surgeon, usually about 2 to 4 weeks after the surgery.

When to Call the Surgeon

You may call the part at whatever time with questions regarding your child'south process. You should call right away if:

Your child has a loftier fever (102 degrees F).
Your kid has an unexplained fever, (i.e., non related to another illness, such as an ear infection).

Complications

After surgery, your child may non exist able to burp or vomit easily. This condition normally is outgrown, only if it is not, your child may need to adjust his or her nutrition to treat it.
Swallowing problems can occur from a wrap that is too tight. These problems can usually be treated by having the doctor dilate (stretch) the narrowed area.
A long-term problem may occur if the wrap comes undone or moves into the chest. If that should happen, your child would exist treated according to his or her symptoms.
During surgery, other complications may occur, such equally bleeding, infection, perforation (puncturing) of the esophagus or stomach, reaction to the anesthesia, or gas escaping from the abdomen during the surgery. Although these complications are rare, your surgeon will discuss them with yous before your child's surgery.

Questions

If you lot have whatever specific questions nearly your child's surgery, you should hash out them with the surgeon earlier the surgery. You may call the Segmentation of Pediatric Surgery at Children's and ask to speak with your child's surgeon, or speak with him or her during the pre-surgical examination on the day of the surgery.

Special Needs

If your child has whatsoever special needs or wellness issues you experience the doctor needs to know about, please call the Division of Pediatric Surgery at Children's before the surgery and ask to speak with a nurse. It is of import to notify us in advance about whatsoever special needs your child might take.