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Anti-reflux surgery - children - discharge
Fundoplication - children - discharge; Nissen fundoplication - children - discharge; Belsey (Mark IV) fundoplication - children - discharge; Toupet fundoplication - children - discharge; Thal fundoplication - children - discharge; Hiatal hernia repair - children - discharge; Endoluminal fundoplication - children - discharge
When Your Child Was in the Hospital
Your child had surgery to treat gastroesophageal reflux disease (GERD). GERD is a condition that causes food or liquid to come up from the stomach into the esophagus (the tube that carries food from the mouth to the stomach).
Your child’s surgeon wrapped the upper part of your child’s stomach around the end of the child's esophagus.
The surgery was done in one of these ways:
- Through a large incision (cut) in your child’s upper belly (open surgery)
- With a laparoscope (a thin tube with a tiny camera on the end)
- By endoluminal repair (like a laparoscope, but the surgeon goes in though the mouth)
Your child may also have had a plyoroplasty procedure to widen the opening between the stomach and small intestine. The doctor may also place a g-tube (gastrostomy tube) in the child's belly.
What to Expect at Home
Most children can go back to school or daycare as soon as they feel well enough.
- Your child should avoid heavy lifting or strenuous activity, such as gym class and very active play, for 3 weeks.
- You may ask your child’s doctor for a letter about the surgery to give to the school nurse and teachers to explain restrictions your child has.
Your child may have a feeling of tightness when they swallow for 6 - 8 weeks. This is from the swelling inside the child's esophagus. Your child may also have some bloating.
Recovery is faster from laparoscopic surgery than from open surgery.
You will need to schedule a follow-up appointment with your child’s primary care provider or gastroenterologist for about a week after the surgery.
After your child goes home, you will slowly get the child back to a regular diet.
- Your child should have started on a liquid diet in the hospital.
- Once the doctor feels your child is ready, you can add soft foods.
- Once your child is taking soft foods well, talk with your child’s doctor about returning to a regular diet.
If your child had a g-tube (gastrostomy tube) placed during surgery, it can be used for feeding and venting. Venting is when the g- tube is opened to release air from the stomach, similar to burping.
- The nurse in the hospital should have shown you how to vent, care for, and replace the g-tube, and how to order g-tube supplies. See also: Gastrostomy tube care
- If you need help with the g-tube at home, contact the home health care nurse who works for the g-tube supplier.
For pain, you can give your child over-the-counter pain medicines such as acetaminophen (Tylenol) and ibuprofen (Advil, Motrin). If your child is still having pain, call your child’s doctor.
If sutures (stitches), staples, or glue were used to close your child’s skin:
- You may remove the wound dressings (bandages) and allow your child to take a shower the day after surgery.
- If your child cannot take a shower, give the child a sponge bath.
If tape strips (Steri-Strips) were used to close your child’s skin:
- Cover the wounds with plastic wrap before showering for the first week. Tape the edges of the plastic carefully to keep water out.
- Do NOT try to wash the Steri-Strips off. They will fall off after about a week.
Do not allow your child to soak in a bathtub or hot tub or go swimming until your child’s doctor tells you it is okay.
When to Call the Doctor
Call your child’s doctor or nurse if your child has:
- A temperature above 101 °F
- Incisions that are bleeding, red, warm to the touch, or have a thick, yellow, green, or milky drainage
- A swollen or painful belly
- Nausea or vomiting for more than 24 hours
- Problems swallowing that keep your child from eating
- Problems swallowing that do not go away after 2 or 3 weeks
- Pain that pain medicine is not helping
- Trouble breathing
- A cough that does not go away
- Any problems that make your child unable to eat
Orenstein S, Peters J, Khan S, Youssef N, Hussain SZ. Gastroesophageal reflux disease (GERD). In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 320.
Kahrilas PJ, Shaheen NJ, Vaezi MF, Hiltz SW, Black E, Modlin IM. American Gastroenterological Association Medical Position Statement on the management of gastroesophageal reflux disease. Gastroenterology. 2008;135:1383-1391.
International Pediatric Endosurgery Group (IPEG). IPEG guidelines for the surgical treatment of pediatric gastroesophageal reflux disease (GERD). J Laparoendosc Adv Surg Tech A. 2009 Apr;19 Suppl 1:x-xiii.
Reviewed By: Robert A. Cowles, MD, Assistant Professor of Surgery, Department of Pediatric Surgery, Columbia University College of Physicians and Surgeons, New York, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.