A Nissen fundoplication is a specialized surgical procedure that reinforces the lower esophageal sphincter—the natural valve between your esophagus and stomach that prevents stomach contents from flowing backward. We understand that chronic acid reflux can severely impact your quality of life, disrupting sleep, meals, and daily activities despite medication. That's why we're committed to providing compassionate, expert care while helping you understand each step of your treatment process.
This focused procedure effectively treats gastroesophageal reflux disease (GERD) that has not adequately responded to medication or for patients seeking an alternative to lifelong medication use. Our approach utilizes advanced laparoscopic techniques through several tiny incisions, creating a 360-degree wrap of the stomach fundus around the lower esophagus. We employ precision measurement and specialized testing to create an individualized wrap that provides optimal reflux control without excessive tightness, resulting in excellent symptom relief while minimizing potential side effects for a dramatically improved quality of life.
You may need a Nissen fundoplication if you experience:
Persistent heartburn or acid regurgitation despite optimal medical therapy
Difficulty swallowing related to reflux-induced inflammation
Aspiration pneumonia from refluxed stomach contents
Chronic cough, hoarseness, or asthma triggered by reflux
Barrett's esophagus (precancerous changes from chronic acid exposure)
Large hiatal hernia contributing to reflux symptoms
Dental erosion from acid reflux
Significant sleep disruption due to nighttime reflux
Dependence on high-dose medications with concerns about long-term use
Regurgitation of undigested food, especially when lying down
Chest pain mimicking cardiac symptoms but related to reflux
Worsening of reflux symptoms despite increasing medication
Post-meal discomfort that affects nutritional intake
Desire for a long-term solution rather than lifelong medication
Lifetime Surgical’s approach to Nissen fundoplication combines precision with personalized care. The procedure begins with a comprehensive preoperative evaluation, including endoscopy, esophageal manometry, and pH testing to confirm the diagnosis and rule out other conditions that may mimic GERD. Notable is our surgeon's expertise in laparoscopic techniques, using five small incisions (typically 5-10mm) to perform this complex procedure with minimal invasiveness and excellent visualization. During surgery, we meticulously dissect the esophageal hiatus, reduce any hiatal hernia, and reconstruct the diaphragmatic opening with specialized suture techniques to prevent future herniation.
Our distinctive approach includes creating a precisely calibrated fundoplication wrap—neither too tight nor too loose—using a sizing bougie to ensure appropriate esophageal diameter. We employ intraoperative testing to confirm the wrap's integrity and appropriate tension, crucial for preventing both recurrent reflux and swallowing difficulties. Throughout your care journey, we implement enhanced recovery protocols specific to anti-reflux surgery, incorporating optimal pain management, early mobility, and carefully planned dietary progression.
Our multidisciplinary team includes dedicated gastroenterologists and nutritionists who provide specialized guidance for the post-operative adjustment period, helping you adapt to your new anatomy and develop optimal eating habits that maintain the integrity of your fundoplication while maximizing comfort and satisfaction with your surgical outcome.
Immediate Post-Procedure (1-3 days)
Expect a hospital stay of 1-2 days for monitoring and pain management
Begin with clear liquids, advancing to full liquids before discharge
Experience some shoulder pain from CO2 gas used during laparoscopy
Use multimodal pain management approaches to control discomfort
Walk frequently to help dissipate gas pain and prevent complications
Work with nursing staff to manage any initial nausea or swallowing adjustments
Learn proper techniques for standing, sitting, and sleeping to minimize strain
Avoid straining, vomiting, or forceful coughing which could stress the new wrap
Receive specific dietary instructions for the first two weeks
Prepare for discharge with a clear understanding of activity restrictions and dietary progression
Short-Term Recovery (1-6 weeks)
Attend your follow-up appointment (typically 7-10 days after surgery)
Progress through dietary stages as directed:
Liquids (weeks 1-2)
Soft, moist foods (weeks 3-4)
Gradual introduction of normal textures (weeks 5-6)
Take small bites, chew thoroughly, and eat slowly at all meals
Avoid lifting anything heavier than 10-15 pounds for 4-6 weeks
Return to work based on your surgeon's recommendation and job requirements (typically 1-2 weeks)
Continue walking daily, gradually increasing distance as comfort allows
Expect some initial difficulty swallowing solid foods (dysphagia) as swelling subsides
Monitor for proper wound healing and report any concerns
Experience relief from reflux symptoms, often immediately after surgery
Learn to recognize normal adjustment symptoms versus potential complications
Avoid carbonated beverages that can cause gas bloat
Long-Term Adjustment (2-6 months)
Continue expanding your diet to include more normal textures and foods
Develop awareness of personal food tolerances as your wrap settles
Return to full physical activities, including exercise, after 6-8 weeks
Resume normal sleeping positions, often without the previous reflux concerns
Notice progressive ease of swallowing as the initial swelling resolves
Experience continued improvement in reflux-related symptoms
Begin reducing or eliminating reflux medications if approved by your doctor
Establish eating habits that promote successful long-term outcomes:
Smaller, more frequent meals
Thorough chewing
Avoiding eating too quickly
Follow up with your gastroenterologist regarding any previous Barrett's esophagus
Long-Term Expectations
Complete internal healing occurs within 3-4 months
Minimal procedure traces that become increasingly subtle over time
Significant reduction or elimination of reflux symptoms for most patients
Reduced or eliminated need for anti-reflux medications
Improved sleep quality without nighttime reflux
Potential improvement in asthma, chronic cough, or hoarseness if reflux-related
Resolution of regurgitation symptoms
Adaptation to modified eating habits becomes routine
Most patients report high satisfaction and improved quality of life
Some patients may experience occasional gas bloating or difficulty belching
Long-term success rates of 85-90% at 10 years for properly selected patients
Annual check-ups help ensure continued reflux control
Common Side Effects
Temporary difficulty swallowing solid foods during the adjustment period
Mild bloating sensation or gas discomfort
Reduced ability to belch or vomit due to the reinforced valve
Early satiety (feeling full quickly)
Temporary discomfort at laparoscopic port sites
Need for dietary modifications with more thorough chewing
Minor shoulder pain from residual CO2 gas
Temporary throat discomfort from intubation during anesthesia
Less Common Complications
Persistent dysphagia (difficulty swallowing) requiring intervention
Gas-bloat syndrome not responding to dietary management
Slipped or unwrapped fundoplication
Recurrent hiatal hernia
Damage to the vagus nerve causing altered stomach emptying
Esophageal or gastric injury requiring repair
Surgical site infection (rare with laparoscopic approach)
Recurrent reflux symptoms (5-10% of patients)
Small bowel obstruction due to adhesions
Splenic injury requiring repair or removal (very rare)
Diaphragmatic injury
Incisional hernia at port sites
When to Seek Immediate Medical Attention
Fever over 101°F (38.3°C)
Severe, worsening abdominal pain
Persistent nausea or vomiting
Complete inability to swallow liquids
Severe chest pain
Shortness of breath
Significant abdominal distension or bloating
Significant redness, warmth, swelling, or drainage at incision sites
Reopening of any surgical wound
Persistent hiccups lasting more than 48 hours
Severe shoulder pain not relieved by walking or pain medication
Signs of dehydration due to inadequate liquid intake
From your first consultation through your complete recovery, we provide:
Thorough evaluation and explanation of your condition
Clear discussion of all treatment options, including non-surgical alternatives when appropriate
Detailed pre-operative instructions to help you prepare
Compassionate care during your hospital stay or outpatient procedure
Comprehensive follow-up care and support during recovery
Ongoing availability to address questions or concerns
We understand that facing head and neck surgery can be intimidating, but you don't have to navigate this journey alone. Our team is committed to providing expert care with a personal touch, ensuring you feel supported, informed, and confident every step of the way.
Your health and wellbeing are our highest priorities, and we're honored to be part of your care team.
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All our laparoscopic procedures are performed by our highly trained surgical team using state-of-the-art equipment and techniques.
We're committed to providing you with the most advanced, minimally invasive options because we believe you deserve:
Less pain after surgery
Shorter hospital stays
Faster return to work and activities you enjoy
Smaller, less visible scars
Lower risk of complications
Better overall outcomes
Dr. Richard Nguyen is a board-certified General Surgeon with over 20 years of surgical expertise and fellowship training in Minimally Invasive and Bariatric Surgery from Vanderbilt University. Since establishing his practice in San Jose in 2007, he has pioneered innovative surgical techniques, including single-incision laparoscopic procedures and mastery of the da Vinci Robotic Surgical System. Beyond his acclaimed bariatric surgery practice, he has earned national recognition for his specialized expertise in both non-mesh and advanced mesh hernia repairs, while also serving as a critical approach surgeon for anterior spine access procedures. Dr. Nguyen combines technical precision with personalized care across multiple premier facilities throughout the South Bay Area.
I would refer Doctor Nguyen to anyone, in fact I have and they have all had the same experience as me. He is truly great. I owe all my success to Doctor Nguyen and I thank him for all the work he has done for me and continues to do so. He is extremely amazing, and I am very grateful to him.
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At 50, I now have a life I had only dreamed of a year before. My body tells me if I am done eating. This surgery is a tool that I have used to the fullest. It is not an easy way out. It still took work. But I honestly know that I would not be living this amazing new life if I didn’t step forward to embrace this life-saving surgery.
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Dr. Nguyen has changed my life completely. I feel so much better and I also feel like I’ve got control of my life again…I had high blood pressure, diabetes and cholesterol. I took at least 5 different medications for the past 30 years. NOW, after surgery I take no medications only vitamins!
Wondering which surgical procedure might be right for your condition? We're here to help you understand your treatment options and develop a personalized surgical plan. Contact our office today to schedule a consultation.
Your path to improved health may be more achievable than you think—with advanced surgical techniques leading to faster recovery, reduced complications, and a significantly enhanced quality of life.