The most important issue in finding a surgeon for anti-reflux surgery is evaluating the surgeon’s experience. (This really applies to any surgery.) Many studies have shown that more surgeon experience is associated with better results in surgery. You would not have heart bypass surgery performed by a surgeon who does one bypass a year—you want a heart surgeon who performs the operation every day or at least a couple times per week. This applies to reflux, too; the more antireflux operations a surgeon does in a year, the better. Because of this fact, you may benefit more by seeing a surgeon at a larger medical center or teaching hospital than by seeing one at a community hospital. Teaching hospitals are bigger, accept more difficult cases, and perform larger volumes of surgery. Community hospitals tend to have general surgeons who operate on many conditions—they remove gallbladders, remove colon cancers, remove breast cancers, and may do antireflux surgery once or twice a year. Because teaching hospitals are larger, surgeons can specialize in particular areas such as stomach surgery.
Younger surgeons have been trained in laparoscopic techniques; this is a relatively new technology. For example, 15 years ago gallbladders were removed by using open surgery. Patients stayed in the hospital for 7 to 10 days and recovered at home for 6 weeks. Now, gallbladders are removed laparoscopically, the patient may stay in the hospital overnight, and then recover for a week or two at home. For anti-reflux surgery, make sure your surgeon is comfortable performing laparoscopic surgery and has performed at least 20 laparoscopic anti-reflux surgeries, because there is a learning curve and practice is important.
Medicine is a business, and surgeons are paid to operate— this could create a conflict of interest. Your surgeon should be methodical in the approach to surgery, ensuring that your evaluation prior to surgery is complete. As previously discussed, a full evaluation generally includes endoscopy, motility studies, and pH studies. These tests help to confirm the diagnosis of acid reflux, assess any damage to the esophagus, and improve surgical results. Anti-reflux surgery is elective surgery, and you should be leery if a surgeon tries to rush you into making a decision or cuts any corners during presurgery evaluation. Ask your surgeon about his or her experience and how patients have done and what complications they have had.
By Mortin - Copyright 2009
Last modification 31/12/2009
How do I Find and Evaluate a Surgeon? References