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Heartburn is a burning sensation in the chest just behind the breastbone. It is a common problem that most people suffer on occasion and effectively treat with over the counter medications when necessary. However, when heartburn occurs with more frequency, it can indicate that a more serious medical condition might be going on. Gastrointestinal reflux or GERD is a chronic condition characterized by frequent bouts of heartburn. If left unchecked, complications of GERD can arise that may be severe and even permanent in some cases.


GERD is a chronic digestive condition that occurs when stomach acid refluxes back into your esophagus. Because the esophagus does not have the same protective lining found in the stomach, the acid can irritate the esophageal lining and cause that familiar burning sensation known as heartburn. People who suffer heartburn more than twice a week or to the point that it interferes with daily, life may be diagnosed with GERD.

Common symptoms of GERD might include the following:

  • Burning sensation in the chest that may spread to the throat
  • Sour or bitter taste in the mouth
  • Feeling like there is a lump in your throat
  • Difficulty swallowing
  • Hoarseness or a chronic cough
  • Chest pain, sometimes mistaken for a heart attack

Common treatments for GERD include medication to reduce stomach acid and heal the esophagus. If medication does not work, surgery may be recommended to stop the damage to the esophagus and prevent further complications from arising.

gerd consultation


Surgery for GERD is typically recommended when other treatment options have not been effective. The standard surgical procedure for this condition is called a Nissen fundoplication. This procedure tightens the muscle at the base of the esophagus, known as the lower esophageal sphincter (LES). By tightening the LES, acid is no longer able to back up from the stomach into the esophagus.

Fundoplication is performed by wrapping the top of the stomach around the lower esophagus. There are a number of potential benefits to this surgery:

  • Relief from painful heartburn symptoms
  • Prevention of future damage to the esophagus
  • Surgical options allow us to tailor your procedure to your needs
  • Many patients find surgery is less painful than expected
  • Recovery times after surgery may be relatively short for some patients


The surgeons at Missoula Surgical Associates offer the following options in fundoplication procedures:

Laparoscopic Fundoplication – This procedure uses special tools and a small camera known as a laparoscope to perform the surgery with very small incisions. The camera magnifies the abdominal cavity to provide greater precision during surgery. Three or four small incisions are typically required for this procedure, which results in less post operative discomfort and a shorter recovery.

Robotic Fundoplication – This procedure is an innovative way to perform surgery, and is even less invasive than laparoscopy. We use the revolutionary da Vinci robotic system to perform fundoplication, using special wrist tools and 3D imaging that enhance precision and control throughout the procedure. The benefits are even shorter recovery times and less blood loss during the procedure.

Open Fundoplication – Traditional fundoplication uses an open approach that involves a larger incision and the surgeon’s own hands to perform the procedure. While this technique is used much less frequently in light of the newer, less invasive techniques, there are still some circumstances where your surgeon may recommend open fundoplication as the best procedure for you.

Fundoplication is a common surgical treatment for GERD. To ensure the best possible outcome from your procedure, choose a surgeon who is well trained and experienced in all types of fundoplication techniques and can recommend the best procedure for your specific needs. To learn more, contact Missoula Surgical Associates at 406.542.7525.