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Laparoscopic Anti Reflux Surgery / Nissen Fundoplication in Singapore

DrGanesh DP 2
Dr Ganesh Ramalingam

Specialist in General Surgery

Procedure

Laparoscopic Anti-Reflux Surgery In A Nutshell

  • Also known as: Nissen Fundoplication

  • Purpose: Long-term treatment for GERD and acid reflux

  • Surgical approach: Minimally invasive (keyhole surgery)

  • Hospital stay: Usually 1–2 days

  • Recovery: Light activities within days, full recovery over weeks

  • Outcome: Reduced reflux, less dependence on long-term medication

Table of Contents

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Laparoscopic Anti Reflux Surgery / Nissen Fundoplication in Singapore

What Is Anti-Reflux Surgery / Nissen Fundoplication?

Nissen fundoplication is a surgical treatment for gastroesophageal reflux disease (GERD). GERD occurs when stomach acid frequently flows back into the oesophagus due to a weak or dysfunctional lower oesophageal sphincter (LES).

During this procedure, the upper part of the stomach is gently wrapped around the lower oesophagus. This strengthens the LES, helping to prevent acid and food from refluxing upward.

By addressing the root cause of reflux, Nissen fundoplication aims to provide long-term symptom control rather than temporary relief.

Who May Benefit from Anti-Reflux Surgery?

Nissen Fundoplication is primarily used to treat patients with GERD, or in other cases, patients diagnosed with a hiatal hernia. This procedure is usually recommended for patients who experience prolonged periods of severe heartburn. This means that there is daily burning pain behind the chest bone for a few months. Surgery is especially indicated if the pain persists despite medication and lifestyle changes.

Nissen fundoplication is usually considered when:

  • Acid reflux symptoms persist despite medication (PPIs, H2 blockers)

  • Symptoms return quickly once medication is stopped

  • There is long-term dependence on reflux medication

  • GERD complications are present (oesophagitis, strictures, Barrett’s oesophagus)

  • A hiatal hernia is contributing to reflux

  • Reflux significantly affects daily life or sleep

Surgery is not the first step for most patients. At G&L Surgical Clinic, conservative options are always explored before surgery is recommended.

How Is Laparoscopic Nissen Fundoplication Performed?

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Most anti-reflux surgeries today are performed using laparoscopic (keyhole) techniques using these steps:

  1. Small incisions are made in the abdomen

  2. A camera and fine instruments are used for precision

  3. The stomach is wrapped around the lower oesophagus

  4. The wrap reinforces the weakened sphincter

Compared to open surgery, laparoscopic fundoplication offers:

  • Less pain

  • Faster recovery

  • Minimal scarring

  • Shorter hospital stay

What to Expect Before, During, and After Nissen Fundoplication

Before the procedure

  • Fasting is required 8 hours prior to your procedure
  • Stop any prescription of aspirin or other blood thinning medications with a doctor’s advice.
  • All regular medications will be stopped unless absolutely necessary under a doctor’s supervision.
  • Be prepared to have an average hospital stay following the procedure in between 2-3 days.

On the day of the procedure

  • This procedure is usually performed under general anaesthesia.
  • Small incisions will be made on the belly for the laparoscope.
  • The length of surgery varies from patient to patient.
  • Your surgeon will advise you on the specific details.

After the procedure

  • Hospital stay of 1–2 days for monitoring
  • Allow a few days for recovery.
  • Avoid heavy lifting for at least a week.

Possible Side Effects and Risks of Nissen Fundoplication

Nissen fundoplication is generally safe when performed by an experienced surgeon. However, as with any surgery, potential risks include:

  • Damage to the linings of the stomach, oesophagus or tissues around the lungs during the procedure
  • Infection from the wound
  • Pneumonia
  • Difficulty in swallowing
  • Nausea or the urge to vomit
  • Excessive gas in the stomach
  • Dumping Syndrome (a condition associated with patients who have done gastric or oesophageal surgery where food moves rapidly through the stomach to the small intestines, resulting in abdominal pain and other symptoms.)

In extremely rare cases, a Nissen Fundoplication may fail and result in the recurrence of the reflux symptoms. In such cases, the wrap around the oesophagus could have been too tight or incorrectly placed, resulting in the need to repeat the surgery to fix the failure.

Are There Any Dietary Restrictions After Anti-Reflux Surgery / Nissen Fundoplication?

A patient who has undergone a fundoplication would be advised to make dietary changes to avoid complications after the procedure. A dietary change can also aid in preventing any long term effects of discomfort following the surgery. Following the surgery, you will be expected to make the changes to your diet according to the different phases. This is what may be recommended:

  • Recovery Phase (2 weeks after surgery): Liquid or soft diet. You are recommended to consume only liquid for the recovery phase and avoid carbonated beverages. Food such as soup and yoghurt are recommended.
  • Acclimatisation Phase (3-4 weeks after surgery): Soft to light solid food diet. You can start introducing solid foods that are easily digestible into your diet. These can include bread, mashed potatoes. Your food should also not be overly spicy or oily to prevent causing discomfort.
  • Maintenance Phase (1 Month after surgery and long term): Solid food diet. You can return to your usual diet. However, you are advised to avoid eating foods that are rough and may become stuck in the oesophagus, such as chicken, steak or nuts.

How Long Does It Take To Recover From Anti-Reflux Surgery / Nissen Fundoplication?

A patient who undergoes a fundoplication procedure can be discharged within two days after the surgery. Patients who opt for open surgery may be required to stay longer as the operation involves a bigger incision, requiring more extended periods to recover. Following the surgery, you will likely require tube feeding in the initial two weeks.

After that, patients will resume consumption of a liquid diet for another two weeks before progressing to soft foods and finally returning to eating normally after 1 to 3 months. Depending on whether you opt for open surgery or laparoscopic surgery for your fundoplication, the recovery of your wound would also differ.

Similarly, the recovery of the wound will differ between individuals. Most patients should recover within two weeks from the surgery if there are no serious complications or infections observed. For a more accurate assessment of your recovery period, you may seek advice from our doctor to get a clearer picture.

Acid Reflux Specialist: Dr Ganesh Ramalingam

Dr Ganesh is experienced in laparoscopic anti-reflux surgery (Nissen Fundoplication) in Singapore and believes that through this procedure, patients will be able to experience greater ease of recovery and comfort, a key priority at G&L Surgical. Nissen Fundoplication is a treatment option recommended for patients in Singapore looking for a reduced recovery period and relief from heartburn and acid reflux related symptoms.  

Our Fees & Costs – Gastroesophageal Reflux Disorder (GERD)

At G&L Surgical, we understand that concerns about treatment costs can add unnecessary stress. Our priority is to provide clarity and reassurance, so you can focus on getting the care you need with peace of mind.

We are committed to transparent pricing and clear financial counselling for all patients undergoing treatment for GERD. For reference, the surgeon’s fee for Nissen fundoplication surgery typically ranges between $9,300 – $14,700 (SF701S/5C). Please note that this amount reflects the surgeon’s fees only and does not include hospital charges, anaesthesia, or consumable fees.

Learn more about costings and insurance claims for Nissen Fundoplication here.

G&L Surgical Provides Medical Services in These Hospitals:

Your medical fees and charges may differ depending on the selection of hospitals and bedding arrangements at different medical institutions.

Dr Ganesh Ramalingam can perform the procedure at the following hospitals:

  • Mount Alvernia Hospital
  • Farrer Park Hospital 
  • Gleneagles Hospital
  • Parkway East Hospital 
  • Thomson Medical Centre
  • Mount Elizabeth (Orchard) Hospital
  • Mount Elizabeth (Novena) Hospital
  • Day surgery centres: HMI, Novena Surgery, Aptus

Frequently Asked Questions

After undergoing Nissen Fundoplication, patients can typically resume eating a normal diet. Patients may be advised to gradually transition from liquids to solid foods. Some patients may also experience difficulty swallowing when eating but this is usually temporary. 

Patients should avoid foods that can irritate the oesophagus or cause acid reflux such as spicy, acidic and high-fat foods or alcohol, caffeine and carbonated beverages. 

Nissen Fundoplication does not typically involve any alteration to the size of the stomach. While the size of the stomach is not changed during Nissen Fundoplication surgery, patients may experience changes in their appetite and eating habits after the procedure.

Eating too much after Nissen Fundoplication surgery can cause discomfort and potentially damage the wrap created during the procedure. If the wrap becomes damaged or loosened, patients may experience symptoms of acid reflux, including heartburn, chest pain, and regurgitation. In some cases, additional surgery may be necessary to repair or replace the wrap.

Coffee can cause discomfort or irritation to the oesophagus, particularly in the first few weeks after surgery. Patients should follow their doctor’s post-operative instructions and gradually reintroduce foods and drinks into their diet as tolerated.

Why Choose Us For Your Anti-Reflux Surgery / Nissen Fundoplication In Singapore?

In this minimally invasive procedure, patients might experience less discomfort and scarring and can engage in normal activities more quickly. Laparoscopic anti-reflux surgery / Nissen Fundoplication by Dr Ganesh Ramalingam at G & L Surgical Clinic in Singapore is preferred by patients looking for a reduced recovery period.

Dr Ganesh at G & L Surgical Clinic strives to prioritise his patients’ recovery and comfort. Having had adequate experience in performing advanced laparoscopic anti-reflux surgeries / Nissen Fundoplications for numerous patients for many years in Singapore.

Furthermore, the staff at G & L Surgical Clinic have been thoroughly and adequately trained to make your experience a comfortable and hassle-free one. Whether you intend to undergo our anti-reflux procedures or other medical services in Singapore, you can rest assured that you will be properly and sufficiently cared for by trained professionals. Organise a consultation with our surgeons for further assistance on anti-reflux treatments in Singapore.