GERD/Hiatal Hernia Surgery & Fundoplication
GERD (acid reflux) & hiatal hernia surgery
When chronic heartburn, acid regurgitation, or difficulty swallowing persist despite daily medications, or when a hiatal or paraesophageal hernia allows the stomach to slide into the chest, minimally invasive foregut surgery can restore the natural barrier between the stomach and esophagus.
- Hiatal hernia surgery: returns the stomach to the abdomen and closes the widened opening in the diaphragm.
- Fundoplication (anti-reflux surgery): wraps the top of the stomach around the lower esophagus to strengthen the valve so acid stops backing up.
Testing before surgery
Before reflux surgery, Dr. Brown usually evaluates the esophagus with an upper endoscopy (EGD), and may check for reflux with MiVu™ mucosal integrity testing during the EGD or measure acid exposure with Bravo wireless pH monitoring. Long-standing reflux can lead to Barrett’s esophagus, which is followed with surveillance EGD and biopsies.
Where surgery is performed
Dr. Brown operates at AdventHealth Port Charlotte and Murdock Surgery Center. Consultations and follow-up visits are at the Charlotte Harbor Surgical office in Port Charlotte.
We care for patients from Port Charlotte, Punta Gorda, North Port, Englewood and across Charlotte County and Southwest Florida.
Frequently asked questions
Does every hiatal hernia need surgery?
No. Small hiatal hernias are common and often cause no symptoms. Surgery is considered when a hernia is large, causes reflux or other symptoms that do not respond to medicine, or leads to complications.
Is a hiatal hernia the same as GERD?
No, but they are related. A hiatal hernia can weaken the barrier that keeps stomach acid out of the esophagus, so many people with a hiatal hernia also have reflux (GERD).
What tests will I need before surgery?
Testing often includes an upper endoscopy (EGD) and imaging such as a barium swallow or CT scan. Some patients also need esophageal function or acid (pH) testing.
How is a hiatal hernia repaired?
Repair is usually done laparoscopically through small incisions. The stomach is returned to the abdomen, the opening in the diaphragm is tightened, and an anti-reflux procedure is often added.
Will I need a special diet after surgery?
Yes, for a short time. Most patients start with liquids and soft foods and slowly return to a regular diet as swallowing feels normal. Your care team will give you written diet instructions.
What is GERD?
Gastroesophageal reflux disease (GERD) is when stomach acid or contents flow back into the esophagus often enough to cause symptoms or irritation, such as heartburn, regurgitation, a sour taste, cough or hoarseness.
What can I do at home to reduce reflux?
Helpful steps include avoiding large or late meals, raising the head of your bed, losing excess weight, stopping smoking and limiting foods that trigger your symptoms.
When should reflux be checked by a surgeon?
Consider an evaluation if symptoms continue despite medicine, if you have trouble swallowing or regurgitation, if you would rather not take medicine long term, or if you have a hiatal hernia.
Will I still need reflux medicine after surgery?
Many patients are able to reduce or stop reflux medicine after anti-reflux surgery, but results vary and some people still need medicine. Your surgeon will discuss what to expect for you.
Can untreated reflux cause problems?
Long-standing reflux can inflame the esophagus and, in some people, lead to narrowing or Barrett’s esophagus. An upper endoscopy (EGD) can check for these changes.
Schedule a consultation with Dr. Brown
Call Charlotte Harbor Surgical in Port Charlotte. Mon–Thu 7:30 am–4:00 pm, Fri 7:30 am–12:00 noon.