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Scott & White Healthcare – Round Rock performing single-incision, laparoscopic surgery for heartburn

Patients who suffer from gastroesophogeal reflux disease (GERD) also known as heartburn can usually be helped by medication, however, many sufferers of daily GERD do not respond to lifestyle changes or drug treatments and may be candidates for anti-reflux surgery, known as a Nissen Fundoplication.  At Scott & White Healthcare – Round Rock, a new technique called Single Incision Laparoscopic Surgery (SILS) is being used to perform the anti-reflux procedure that is designed for patients who suffer from chronic GERD, don’t respond to medication, and meet specific criteria for surgery.

“Surgery is an option when medicine and lifestyle changes don’t work and may be a reasonable alternative to a lifetime of expensive medications and discomfort,” said F. Paul (Tripp) Buckley III, M.D., general surgeon at Scott & White – Round Rock. “The pain, or ‘heartburn’ may go away with medications, but patients still have a sensation of regurgitation.  GERD is a mechanical problem and may require a mechanical solution,” said Dr. Buckley, who’s also assistant professor of surgery at Texas A&M Health Science Center College of Medicine. “With the SILS Nissen Fundoplication procedure for GERD, the uppermost part of the stomach (fundus) is snuggly wrapped around the esophagus to create a barrier to the upward reflux of stomach acid. Additionally, a hiatal hernia that is often present is repaired.  This is all done through one tiny incision instead of five for the standard laparoscopic approach.”

According to Dr. Buckley, surgery for GERD may be necessary when:

  • medicines and lifestyle changes have failed to control symptoms
  • patients can’t afford or don’t want to take medication to treat their symptoms
  • patients have certain complications or conditions resulting from GERD

This procedure is performed through a single small (less than an inch) incision in the belly-button. After healing has taken place, the scar is hidden and may not be seen. This procedure is a further evolution of the current laparoscopic technique that has been used safely and effectively in people of all ages. “Patients can typically leave the hospital the next day and return to work in two weeks,” said Buckley.

The potential benefits of the SILS Nissen fundoplication surgical procedure for GERD include:

  • Single incision in the belly-button with little or no scarring
  • Decreased risk of infection or bleeding after surgery
  • Faster recovery
  • Less pain
  • Faster return to normal activities

Dr. Buckley emphasizes that “At Scott & White- Round Rock, we take a multi-disciplinary approach to treating our patients and it’s no different for those who suffer from acid-reflux and GERD and its complications.  All patients are thoroughly evaluated by both the surgeon as well as one of our gastroenterologists.” Our team of gastroenterologists plays an integral role to ensuring each patient has received optimal medical care.”

“While most patients with GERD can be managed with medicines and/or lifestyle changes, it’s important to note that GERD can lead to serious complications,” said Benjamin Havemann, M.D., division director of gastroenterology at Scott & White Round Rock and assistant professor of medicine at Texas A&M Health Science Center College of Medicine.  “Chronic inflammation of the esophagus from GERD is associated with ulceration, bleeding, trouble swallowing, and with the development of esophageal cancer.  Some patients with GERD harbor a cellular mutation called “Barrett’s esophagus,” which is now the precursor for most cases of esophageal cancer in the U.S.”

Dr. Havemann went on to say that “we work closely together to optimize patient care, recognizing that GERD can be managed through both medical and surgical therapies. Our multidisciplinary approach at Scott & White allows us to look at the problem from both sides.  This collaborative, patient-centered approach is one of the unique attributes of our model of care.”

Dr. Buckley leads a team at Scott & White-Round Rock that has performed numerous SILS procedures for a variety of surgical conditions including, cholecystectomy (removal of the gallbladder), appendectomy, colon resection, liver resection, partial kidney removal, hernia repair, and colostomy reversal.

Scott & White – Round Rock is a training site for the SILS approach. Surgeons travel from across the country to visit and learn about SILS procedures. Dr. Buckley also lectures around the country on new and innovative applications of the SILS technique. In addition to Dr. Buckley, the general surgery team performing SILS at Scott & White – Round Rock includes Drs. Rob W. Watson and John F. Eckford. Drs. Watson, Eckford and Buckley are all Board Certified surgeons and hold academic appointments through Texas A&M College of Medicine.

For Dr. Buckley, “the most rewarding aspect of surgery for me is when a patient who has been suffering from chronic reflux for years comes back in for a post-procedure visit and says that they feel like their life is back to normal again.  In the end, that is why we are here.”

Currently, fewer than one percent of surgeons are utilizing the single incision laparoscopic approach, however all of the general surgeons at Scott & White – Round Rock do.

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