personalized reflux surgery for the best outcomes

personalized care.

robotic precision.

There is no one-size-fits-all treatment for heartburn and reflux, and research is showing more and more that patients require a tailored approach to their disease. Schedule a consultation to see what’s best for you.

Summary

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  • Up to 2 in 5 people in the U.S. have symptoms of heartburn, with 70% of those patients on acid-reducing medication. The chronic reduction in stomach acid has led to a number of long term health problems, including brittle bones, kidney problems, gut bacterial imbalances, and significant indigestion. Untreated, chronic or severe heartburn can potentially lead to the development of esophageal cancer.

    • Esophagitis (inflammation of the esophagus)

    • Dysphagia (trouble swallowing)

    • Odynophagia (painful swallowing)

    • Barrett’s Esophagus (potentially precancerous change in esophagus lining)

    • Hiatal hernia (stomach or other organs move up into the chest)

    • Achalasia (narrowing of the esophagus)

  • Symptoms from reflux, especially long term reflux, can range from the typical feeling of heartburn, to pain or difficulty swallowing, the sensation of food getting stuck, or having to swallow multiple times to get something down. Overlap of esophageal diseases and symptoms is significant. Symptoms could indicate any number these esophageal diseases.

  • Testing for esophageal diseases is varied, and often requires a GI specialist trained in endoscopy. Tests will investigate the ability of the esophagus to push food down into the stomach, the quality of the lining of the esophagus, the presence or masses, or significant narrowing.

  • Surgical treatment will depend on the disease, but will often be in the form of a “fundoplication,” where the upper portion of the stomach is wrapped around the lower part of the esophagus. Because of the potential for significant side effects, more recent research has shown that these surgeries must be tailored specifically to each patient. This allows for the best possible outcomes and recovery.

Reflux & Heartburn

Reflux and heartburn occur when the lower esophageal sphincter (LES)—a ring of muscle at the bottom of the esophagus—fails to function properly. Normally, the LES acts as a one-way valve, preventing stomach acid from flowing back up. However, when it weakens or relaxes inappropriately, acid and digestive enzymes escape into the esophagus, irritating its lining and causing the burning sensation known as heartburn. Factors like obesity, diet, hiatal hernias, and certain medications can contribute to LES dysfunction. Over time, repeated exposure to acid can lead to inflammation, scarring, and even precancerous changes in the esophagus, making proper management crucial.

Chronic acid reflux can lead to a condition called Barrett’s esophagus, where the normal lining of the esophagus is replaced by abnormal, intestinal-type cells in response to prolonged acid exposure. This change increases the risk of esophageal adenocarcinoma, a serious form of cancer. While not everyone with Barrett’s esophagus will develop cancer, the condition requires careful monitoring through regular endoscopies and biopsies to detect any progression toward dysplasia, the earliest precancerous stage. Early intervention—whether through medication, lifestyle changes, or advanced treatments like endoscopic ablation—can significantly reduce the risk of cancer and protect long-term esophageal health.

A hiatal hernia occurs when part of the stomach pushes up through the diaphragm into the chest cavity, often weakening the lower esophageal sphincter (LES) and making acid reflux more likely. Normally, the diaphragm helps support the LES, acting as a barrier to prevent stomach contents from flowing back into the esophagus. When a hiatal hernia is present, this support is compromised, allowing acid and digestive enzymes to escape more easily, leading to chronic reflux and heartburn. While small hiatal hernias may not cause symptoms, larger ones can contribute to gastroesophageal reflux disease (GERD) and may require medical or surgical intervention for relief.

A large percentage of patients with heartburn and reflux tend to have a hiatal hernia present, but if its diagnosis isn’t suspected or searched for, many are placed on lifelong acid reduction medications, such as Protonix or Nexium.

Long-term suppression of gastric acid, commonly with proton pump inhibitors (PPIs) such as pantoprazole, or H2 blockers, can be effective for managing acid reflux and ulcers, but prolonged use carries potential risks. Stomach acid plays a crucial role in digestion, nutrient absorption, and immune defense. Chronic acid suppression can lead to deficiencies in vitamin B12, calcium, magnesium, and iron, increasing the risk of osteoporosis, fractures, and anemia. It also can alter the gut microbiome, making patients more susceptible to infections and small intestinal bacterial overgrowth, which can lead to a myriad of digestive issues. Additionally, some studies suggest a potential association with chronic kidney disease and dementia, and even stomach cancer. Most patients benefit long term from surgery, which can completely eliminate the need to take long term acid suppression.

Robotic anti-reflux surgery

Dr. Le has particular interest in GERD and anti-reflux surgery. Robotic-assisted anti-reflux surgery offers a highly precise, minimally invasive solution for patients with chronic acid reflux or gastroesophageal reflux disease (GERD). Using advanced robotic technology, the procedure allows for greater precision, improved visualization, and enhanced dexterity, leading to a more effective and durable repair with less tissue trauma. A truly individualized approach is key to achieving optimal outcomes—tailoring the procedure to factors like the severity of reflux, presence of a hiatal hernia, and each patient’s unique anatomy. By customizing the surgical plan, we can ensure the best balance between symptom relief, a natural swallowing function, and long-term success, helping patients regain their quality of life with minimal downtime.

Before Surgery

  • You will be seen by Dr. Le in the clinic for a comprehensive history and physical, and to discuss your symptoms specific to your problem.

  • Testing for reflux can be extensive depending on symptoms, but include upper endoscopy, barium esophagram, and esophageal manometry.

  • Follow up visit or telehealth visit to discuss results of testing if needed.

  • Smoking cessation for 2 weeks before and 2 weeks after surgery to lower anesthetic risks.

  • Prepare for surgery.

After Surgery

  • Most of the time, you will be admitted overnight for monitoring.

  • No heavy lifting more then 30 lbs for about 3 weeks, with a slow and steady increase back to normal activity over 2 weeks after that.

  • You will be permitted to shower 24 hours after your surgery, patting dry the areas of your incisions.

  • A soft mushy diet, free from meat, chewy breads, and carbonated beverages for 1-2 weeks after surgery will be recommended.

  • You will be scheduled for at least one followup visit about 1 week after your operation.

additional services we offer

Gallbladder Surgery

GALLBLADDER DISEASES

Cutting edge techniques to remove the gallbladder through “hidden incisions,” as well as single-anesthesia operations to remove stones stuck in the biliary tubes.

STOMACH PROBLEMS

Trusted expertise in a vast range of surgical and functional stomach problems that can often present with vague symptoms, finally getting you answers.

HERNIAS

Innovative approaches to all types of abdominal and groin hernias, decreasing pain and allowing faster return to everyday activities.

SMALL BOWEL DISEASES

Leading-edge surgical techniques in a wide array of common and uncommon small bowel diseases, supporting you in your treatment journey.

COLON DISEASES

Progressive, patient-centered operations and treatments, from hemorrhoids to colon cancer, decreasing your time in the hospital so you can get home faster.

GENERAL SURGERY

Lumps and bumps, lacerations, cysts, and many other problems can be treated by general surgeons.

MALS

Median arcuate ligament syndrome, a rare and difficult diagnosis, requires expertise and precision to treat. See why Dr. Le is at the forefront.

SMAS

Superior mesenteric artery syndrome requires expert diagnosis and treatment. Dr. Le has developed a new surgical treatment with excellent results.