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Esophageal and reflux surgery in Tijuana
Surgical treatment of gastro-oesophageal reflux disease and of oesophageal pathology, when medication no longer controls the symptom or when a complication has appeared.
The reflux that is genuinely surgical
Gastro-oesophageal reflux disease is extraordinarily common and in most cases is controlled with proton-pump inhibitors and changes of habit: losing weight, eating dinner three hours before bed, raising the head of the bed, stopping tobacco and alcohol.
Reflux becomes surgical in four scenarios. When the symptom persists despite properly conducted and properly taken medical treatment. When the patient does not want to depend on a medication for decades. When complications already exist: severe oesophagitis, peptic stricture, Barrett's oesophagus. And when the manifestations are extra-digestive and persistent: chronic cough, laryngitis, morning hoarseness, difficult asthma.
What must be investigated before operating on reflux
This is the part that separates a well-indicated anti-reflux operation from one that creates new problems. Before scheduling, endoscopy with biopsies is needed, to document mucosal damage and rule out other causes of the symptom. And in most cases, functional studies: oesophageal manometry and 24-hour pH monitoring.
Manometry shows how the oesophagus moves, and that determines what kind of valve can be built. pH monitoring documents that the symptom genuinely corresponds to acid reflux episodes, and not to something that resembles them. Operating on «reflux» that was in fact a motility disorder is the well-known way to leave a patient worse than before.
The operation and what it resolves
The usual procedure is laparoscopic fundoplication, with hiatal repair where an associated hernia is present. A segment of oesophagus is restored within the abdomen, the hiatus is closed and a valve is built from the gastric fundus, complete or partial according to documented motility.
In patients with obesity the conversation changes: reflux improves substantially with weight loss, and in many cases the indicated procedure is not a fundoplication but a gastric bypass, which solves both problems at once. That joint assessment is part of the consultation and avoids operating twice on what could have been resolved once.
What the procedure involves
When it is indicated
- GERD unresponsive to properly conducted medical treatment
- A wish to stop long-term pharmacological treatment
- Severe oesophagitis, peptic stricture or Barrett's oesophagus
- Persistent respiratory manifestations attributable to reflux
- Hiatal hernia associated with reflux symptoms
- Reflux in a patient with obesity, assessed alongside bariatric options
Techniques and resources
- High-definition laparoscopic tower
- Oesophageal calibration bougie
- Mesh for selected large hiatuses
- Supporting manometry and pH monitoring
- Intraoperative endoscopy where required
Frequently asked questions about esophageal and reflux surgery
In many patients it controls the symptom for a long time and allows medication to be stopped. A permanent result is not promised in every case: the valve can loosen over time, especially if factors such as overweight or repeated abdominal straining persist.
It is a change in the lining of the lower oesophagus caused by chronic acid exposure. It matters because it means scheduled endoscopic surveillance, and because its presence changes the conversation about treatment. It is diagnosed with endoscopy and biopsies, not from symptoms.
That is exactly why manometry is requested before operating. If the study shows a motility disorder, treatment is different and a fundoplication would make matters worse. That finding changes the plan — and finding it is precisely the point of investigating before scheduling.
Bring your studies and settle the question
One consultation with your ultrasound or CT in hand is worth more than ten internet searches. Book by phone or through the form and you will be told what is there, what it means and what your options are.