GERD Surgery in Ankara, Turkey

GERD surgery is a surgical treatment method that aims to permanently prevent stomach acid from flowing back into the esophagus. It is performed in advanced cases of reflux disease that do not respond to medication and is usually carried out using laparoscopic techniques.

The reflux surgery process is performed with a method called fundoplication, in which the upper part of the stomach is wrapped around the esophagus. This procedure strengthens the lower esophageal sphincter and prevents acid reflux. After the operation, patients’ quality of life increases significantly.

The recovery period after GERD surgery is short, and patients are usually discharged within a few days. Nutrition is arranged gradually: patients start with liquids and transition to a normal diet over time. Regular follow-up with the doctor is important during recovery.

Long-term outcomes after reflux surgery are generally very positive. Most patients no longer need to use medication, irritation of the esophagus decreases, and the risk of complications is reduced. However, as with any surgical procedure, the possibility of complications should be considered.

You can contact Prof. Dr. Ebru Soy, one of the doctors performing GERD Surgery in Ankara, to get information about GERD Surgery prices, the process, and the hospital where GERD Surgery is performed.

What Is GERD?

GERD is a digestive disorder caused by stomach acid flowing back into the esophagus. This condition develops because the lower esophageal sphincter is weak.

What Is GERD Surgery?

You can think of the junction where the esophagus meets the stomach as the front door of a house. Normally, this “door” closes tightly after food enters the stomach and prevents acidic stomach contents from leaking upward into the esophagus. In GERD, the door’s hinges are damaged and the lock has loosened. Sometimes, part of the stomach herniates into the chest (hiatal hernia), and the door shifts out of place entirely. As a result, stomach acid and digestive fluids repeatedly flow upward, causing the classic burning sensation in the chest, bitter fluid in the throat, and other symptoms that can seriously affect daily life.

Acid-suppressing medications reduce irritation by weakening stomach acid—like reducing the pressure of water to lessen the damage from a leak. However, they do not repair the faulty “door.” As soon as the medication is stopped, the acid returns to its original strength and symptoms often come back. In some cases, even if acid is reduced, non-acidic contents such as bile may continue to reflux upward, especially at night, causing choking sensations during sleep or regurgitation of food.

GERD surgery takes a different approach: instead of managing the leak, it repairs the door. Using the laparoscopic (minimally invasive) fundoplication method—considered the gold standard today—the upper, dome-shaped part of the stomach (fundus) is wrapped around the lower end of the esophagus like a scarf to create a natural barrier. This strengthens the weakened valve mechanism, repairs a hiatal hernia if present, and prevents reflux in a long-lasting way. In other words, surgery provides a mechanical solution that addresses the root cause, rather than only suppressing symptoms.

In Which Cases Is GERD Surgery Performed?

The decision for GERD surgery is not as simple as “I have reflux, so I should have surgery.” It is an individualized decision based on the patient’s overall condition, symptom severity, and the results of detailed diagnostic tests. Proper patient selection is the foundation of surgical success. Situations in which surgery becomes a strong option include:

• Symptoms not being controlled with medication
• Persistent bitter fluid or food regurgitation
• Not wanting to remain dependent on lifelong medication
• Experiencing side effects from medications
• Severe esophageal injury due to reflux (esophagitis)
• Large hiatal hernias that cannot be managed medically
• Presence of Barrett’s esophagus
• Persistent cough caused by reflux
• Ongoing hoarseness
• Recurrent lung infections (aspiration)
• Development of esophageal narrowing (stricture)

Before making this decision, it is essential to confirm the diagnosis and determine the most appropriate surgical technique with a series of key tests. This preparation process creates the surgical roadmap. The main evaluations include:

• Endoscopy
• Manometry (esophageal pressure testing)
• 24-hour pH monitoring
• Contrast swallow study (barium swallow)

Endoscopy is performed using a thin, flexible tube with a camera to examine the inside of the esophagus and stomach. This helps us see how much damage reflux has caused, whether there is a hiatal hernia and how large it is, and whether another issue (such as an ulcer) could be contributing to symptoms.

Manometry is arguably the most critical test for surgical planning. It measures esophageal contraction strength and swallowing performance. Think of it like this: surgery will create a tighter “door.” But does the esophagus have enough strength to push food through this new door into the stomach? Manometry answers that question. If esophageal motility is weak, a looser wrap (partial fundoplication) can be chosen to minimize the risk of post-operative swallowing difficulty.

24-hour pH monitoring is considered the gold standard for confirming GERD. It is especially helpful when endoscopy does not show significant injury but typical symptoms exist. A very thin probe placed through the nose records how much acid enters the esophagus over 24 hours. This test scientifically proves whether symptoms are truly caused by reflux or another sensitivity.

A contrast swallow study is a radiologic examination often requested when a large hiatal hernia or swallowing difficulty is suspected. While the patient drinks a barium-containing liquid, real-time imaging allows assessment of swallowing function and the structure of the hernia.

What Are the Risks of GERD Surgery?

As with any surgical intervention, GERD surgery has potential risks and possible side effects. Fortunately, with today’s minimally invasive techniques, these risks are relatively low and most are manageable. Knowing these possibilities helps set realistic expectations. The most commonly encountered issues specific to this surgery include:

• Temporary difficulty swallowing after surgery
• Gas, bloating, and difficulty burping
• A feeling of abdominal fullness
• Increased flatulence
• Changes in bowel habits such as diarrhea or constipation
• Recurrence of reflux symptoms over the years

Among these, the most common and most frequently asked-about issues are swallowing difficulty and gas-bloat symptoms. During the first few weeks after surgery, nearly every patient experiences some degree of swallowing difficulty due to swelling (edema) around the surgical area. This is a normal part of healing and is usually managed easily with a special diet. As swelling subsides, swallowing returns to normal. Rarely, if the wrap is too tight, persistent difficulty swallowing can occur—this is often treated with endoscopic dilation.

Gas-bloat syndrome occurs because the newly reinforced valve mechanism may make it harder for swallowed air to escape through burping. This can be somewhat more common after a full 360-degree wrap (Nissen). Patients may feel bloated or overly full. This usually improves over time as the body adapts. Choosing the right technique before surgery (such as a partial wrap) can significantly reduce the likelihood of this side effect.

How Is GERD Surgery Performed?

GERD surgery is now typically performed laparoscopically (minimally invasive). Instead of a large abdominal incision, the surgeon works through a few small 0.5–1 cm openings using a camera and long, precise instruments. The benefits are substantial: less post-operative pain, a shorter hospital stay (usually 1–2 nights), faster recovery and return to daily life, and minimal scarring.

The operation is performed under general anesthesia and typically takes about 1.5 hours. The main steps are similar regardless of technique. First, carbon dioxide gas is used to gently inflate the abdomen to create working space. Next, any herniated stomach and the esophagus are brought back into the abdominal cavity. The widened opening in the diaphragm (hiatus) is tightened with sutures. Finally, the upper part of the stomach is wrapped around the esophagus to create a new valve mechanism. The main techniques include:

• Nissen Fundoplication (360-degree full wrap)
• Toupet Fundoplication (270-degree partial wrap)

Nissen fundoplication is the oldest and best-known technique, in which the stomach is wrapped completely around the esophagus like a ring. It is highly effective in controlling reflux. Toupet fundoplication is a more modern approach: the stomach is wrapped around the back and sides of the esophagus in a 270-degree “horseshoe” configuration, leaving the front side free. Many scientific studies show that Toupet’s reflux control is nearly equivalent to Nissen, while the rates of swallowing difficulty and gas-bloat symptoms are significantly lower. For this reason, it is often preferred today—especially in patients with weaker esophageal motility or when minimizing side effects is a priority.

If severe obesity accompanies reflux symptoms, the preferred surgical approach may be different. In such cases, bariatric procedures such as sleeve gastrectomy or gastric bypass can offer a more effective solution by treating both reflux and obesity at the same time.

Recovery After GERD Surgery

Recovery after laparoscopic GERD surgery is usually quite comfortable. Patients typically stay in the hospital for 1 night and can go home the next day. The most important focus after surgery is diet. Because of tenderness and swelling at the surgical site, a step-by-step diet plan is used to help food pass comfortably.

For the first few days, only clear, strain-free liquids are recommended, such as:

• Water
• Apple juice
• Clear compote without pulp
• Broth
• Herbal teas such as linden tea

The second stage, which lasts about two weeks, involves pureed and blended foods. Some suitable options include:

• Creamy, smooth soups
• Yogurt, ayran
• Pudding or milk-based desserts
• Blended vegetable and fruit purees
• Protein-enriched milk drinks

From the end of the second week until around the sixth week, patients gradually transition to soft foods. Examples include:

• Boiled or baked fish
• Chicken or meatballs (as minced/soft form)
• Mashed potatoes
• Well-cooked, peeled vegetables
• Omelet or soft-boiled eggs
• Bananas

During this period, foods that are dry, sticky, or difficult to swallow—such as bread, rice, pasta, raw vegetables, and tough meats—should be avoided. Carbonated drinks are strictly prohibited.

In terms of physical activity, patients can start walking the day after surgery. However, strenuous exercise that strains the abdominal muscles and lifting more than 10 kg should be avoided for about 4–6 weeks.

What to Pay Attention to After GERD Surgery

To maintain long-term success and enjoy a comfortable life, adopting a few simple lifestyle habits is very important. These guidelines help you live in harmony with your new stomach anatomy. Key points include:

• Always eat small portions.
• Chew each bite very well.
• Eat slowly in a calm environment.
• Finish dinner at least 2–3 hours before bedtime.
• Avoid drinking excessive liquids during meals.
• Maintain healthy weight control.
• Avoid carbonated beverages long term.
• Stop habits that increase swallowed air, such as chewing gum or using straws.

In properly selected patients, GERD surgery has a success rate above 90% and can free patients from medication dependence while significantly improving quality of life. This surgery is not an end—it is the beginning of a healthier, more comfortable life. Following these simple rules after surgery helps ensure that this new start lasts for years to come.