What is gerd / anti-reflux?
Gastro-oesophageal reflux disease (GERD) occurs when the valve between the stomach and food-pipe weakens, allowing acid to flow back up. This causes heartburn, regurgitation and, over time, damage to the lining of the oesophagus. A hiatal hernia — where part of the stomach slides up through the diaphragm — is a common underlying cause.
Most patients are managed first with lifestyle changes and acid-suppressing medicines. When symptoms persist, worsen, or the patient does not want lifelong tablets, anti-reflux surgery (fundoplication) and repair of the hiatal hernia offer a durable solution — performed laparoscopically or robotically for a faster recovery.
Symptoms & when surgery is needed
How it is diagnosed
- Upper GI endoscopy to assess the oesophagus, valve and any hiatal hernia
- 24-hour pH and impedance study to confirm and quantify reflux
- Oesophageal manometry to check swallowing muscle function before surgery
- Barium swallow to map a hiatal hernia and rule out other causes
Treatment options
Laparoscopic Nissen fundoplication
The upper stomach is wrapped around the lower food-pipe to rebuild the anti-reflux valve — the standard keyhole operation for GERD.
Toupet (partial) fundoplication
A partial wrap used when swallowing function is reduced, balancing reflux control with comfortable swallowing.
Hiatal hernia repair
The stomach is returned below the diaphragm and the widened hiatus is repaired, often with the fundoplication.
Robotic anti-reflux surgery
Wristed precision and 3D vision help with large hiatal hernias and re-do surgery.
The procedure, step by step
- 1
Assessment
Endoscopy, pH study and manometry confirm reflux and plan the right type of wrap.
- 2
Anaesthesia & access
Under general anaesthesia, a few keyhole ports are placed (or the robot is docked).
- 3
Hiatal repair
Any hiatal hernia is reduced and the diaphragm opening is tightened around the food-pipe.
- 4
Fundoplication
The top of the stomach is wrapped to recreate a one-way valve that stops acid flowing back.
- 5
Recovery
Most patients start liquids the same day and go home within one to two days.
Recovery timeline
1–2 days
Short hospital stay; a staged liquid-to-soft diet begins.
1 week
Return to desk work; soft diet continues as swallowing settles.
2–4 weeks
Gradual return to a normal diet and routine activity.
6 weeks
Full diet resumed; most patients are off reflux medication.
Risks & considerations
- Temporary difficulty swallowing or bloating as the wrap settles
- Inability to belch or increased wind in the early weeks
- Recurrence of reflux or hernia over the long term (uncommon)
- General risks of anaesthesia and keyhole surgery
Cost in Hyderabad
| Procedure | Indicative range |
|---|---|
| Laparoscopic fundoplication | ₹1,50,000 – ₹2,75,000 |
| Laparoscopic hiatal hernia repairLarge hernias may need mesh | ₹1,60,000 – ₹3,00,000 |
| Robotic anti-reflux surgery | ₹2,25,000 – ₹3,75,000 |
| Re-do / complex anti-reflux surgeryDepends on previous surgery | On assessment |
These are indicative ranges for Hyderabad and vary with the grade or complexity of the condition, the technique chosen, implants used, room category and insurance. They are not a quotation. Please contact the clinic for a personalised estimate after consultation.
Why choose Dr. Satish Reddy
Frequently asked questions
Surgery is considered when reflux persists despite proper medication, when there is a significant hiatal hernia, when complications like oesophageal damage develop, or when a patient does not want to take acid-suppressing tablets lifelong. A pH study and endoscopy help decide.
For most patients fundoplication gives long-lasting relief and they come off reflux medicines. A small number may see reflux return over many years, which can usually be managed medically or, rarely, with re-do surgery.
Yes. There is a short period of a soft diet while the wrap settles, and mild swallowing difficulty or bloating can occur early on. Most people return to a normal diet within a few weeks.
Almost always. Anti-reflux surgery and hiatal hernia repair are performed laparoscopically or robotically through small incisions, which means less pain and a quicker recovery than open surgery.
Medically reviewed by Dr. Y. Satish Reddy
MS, PDF (Surgical Gastroenterology) · Updated 1 September 2026