Zurich Reference Center for Reflux Surgery

Medical Director: Mischa Feigel, MD, Specialist FMH for Surgery, esp. Visceral Surgery

Chronic gastroesophageal reflux disease / hiatal hernia

Introduction

Acid regurgitation and a burning sensation behind the sternum is usually the result of an insufficient closure mechanism between the esophageal outlet and the gastric inlet. As a result, more gastric acid enters the esophagus. The mucosa of the esophagus is exposed to this acid without protection and causes the typical complaints. As a result of chronic acid exposure, inflammation of the esophagus often occurs as well. For this reason, larger amounts of acid, stomach contents and bile should be prevented from entering the esophagus. Sometimes a change in diet, eating early at night, sleeping with the upper body slightly elevated, or weight reduction helps. If these simple measures show no or only insufficient success, medications can be used to either protect the mucous membrane of the esophagus from the acid with a kind of film or to reduce or block the acid production in the stomach. However, this does not improve the insufficient closure between the esophagus and the entrance to the stomach. The exact causes of reflux disease are not known. However, the main reason for the symptoms and possible esophagitis is the mechanical problem mentioned above. This can only be corrected by surgery which prevents pathological reflux of gastric acid, gastric contents and bile from the stomach into the esophagus. Inflammation of the esophagus should not occur afterwards, so that the use of medication is usually no longer necessary. We perform the procedure minimally invasive (laparoscopic) by laparoscopy.