During a fundoplication procedure, the fundus (the top part of the stomach) is wrapped around the esophagus and sutured (stitched) in place. The wrap acts as a valve to keep stomach acid from moving up into the esophagus, which is the problem with GERD.

Northwestern Medicine surgeons use the EsophyX® procedure to treat GERD, which is an incisionless fundoplication procedure through the mouth. The EsophyX® offers all the advantages of traditional minimally invasive techniques without skin incisions.

Minimally invasive procedures such as incisionless fundoplication have been shown to offer an array of potential benefits, including greater surgical precision, better outcomes, a shorter recovery time, shorter hospital stay and less pain.

One of these three approaches will be used:

• Dor (anterior) fundoplication: This frontal approach is the most common anti-reflux surgery. Part of the stomach (called the fundus) is laid over the front of the esophagus and stitched in place. When the stomach contracts, a seal is made at the esophagus.
• Toupet (posterior) fundoplication: This rear approach stitches the fundus across the back of the esophagus.
• Nissen (complete) fundoplication: This approach wraps the fundus completely around the esophagus. It is not advised for patients with achalasia because it may cause problems with peristalsis (the movements that help send food down the esophagus).

Conditions this treatment is offered for:

• Gastroesophageal reflux disease (GERD)
• Hiatal hernia