Appointment Request


Locations
North Knoxville

7557A Dannaher Drive, Suite 110
Powell, TN 37849
865.938.8121

North Knox & Physicians Regional Surgeons

David J. Harrell, MD, FACS

Jose Luis Mejia, MD, FACS

Roland B. Weast, MD, FACS


Parkwest

9430 Park West Boulevard, Suite 310
Knoxville, TN 37923
865.690.5263

Parkwest Surgeons

Willard B. Campbell, MD, FACS

William C. Gibson, MD, FACS

Michael E. Kelly, MD, FACS

Kristopher B. Williams, MD


Fort Sanders Regional

1819 Clinch Avenue, Suite 200
Knoxville, TN 37916
865.524.3695

Fort Sanders Surgeon

Joel F. “Trey” Bradley, III, MD


Video

In this video Dr. David Harrell performs a robotic nissen fundoplictaion using the daVinci Xi system. Click box to view.
Dr. Harrell Robotic Nissen Fund

Acid Reflux Relief

If you have heartburn or reflux twice a week or more, you may have Gastroesophagael Reflux Disease, also known as GERD. Approximately 30-40% of American adults are affected by GERD. Heartburn is the most common symptom, but you may also experience:

  • Hoarseness or sore throat
  • Frequent swallowing
  • Asthma or asthma-like symptoms
  • Pain or discomfort in the chest
  • Sleep disruption (unable to sleep lying down)
  • Bloating
  • Excessive clearing of the throat
  • Persistent cough
  • Burning in the mouth or throat
  • Intolerance of certain foods
  • Dental erosions or therapy-resistant gum disease or inflammation

Normally, after swallowing, a valve between the esophagus and stomach opens to allow food to pass and then closes to prevent stomach contents from “refluxing” back into the esophagus. For people who suffer from GERD, the valve is dysfunctional and unable to prevent acid from refluxing into the esophagus, thus a burning sensation in the chest.

If your chronic acid reflux symptoms persist despite dietary changes and medication therapy, antireflux surgery can be effective in treating GERD.

Hiatal Herniahiatal hernia

A hiatal hernia occurs when the opening in your diaphragm where the esophagus passes through to connect to the stomach is too large. The stomach may bulge through this opening into your chest. This bulging is called a hiatal hernia. It may make GERD symptoms worse. A hiatal hernia may be repaired in conjunction with antireflux surgery.

Antireflux Surgery

(also called Fundoplication)Nissen Fundoplication

This procedure attempts to recreate the “valve” between the esophagus and the stomach by wrapping the upper portion of the stomach around the lower part of the esophagus and sewing it into place. This tightens the lower esophagus, helping to prevent acid from moving from the stomach up into the esophagus.

This procedure is usually performed laparoscopically or robotically. In a laparoscopic procedure, the surgeons use a tiny incision to enter the abdomen through cannulas (narrow tube-like instruments). A laparoscope is inserted through the incision, giving the surgeon a magnified view of the patient’s internal organs. The operation is performed inside the abdomen while it is inflated with gas.

After surgery, patients are on a liquid or soft diet for several weeks as your esophagus heals. The diet helps control breathing problems, diarrhea, and excess gas after the procedure. Most people are able to go back to work and resume their normal routine within 2 to 3 weeks.

TIF

(Transoral Incisionless Fundoplication)trans-oral-incisionless-fundoplication-300x262

TIF is another treatment for chronic acid reflux disease, also known as (GERD). TIF reconstructs the antireflux barrier between the stomach and esophagus to provide a solution to the anatomical cause of GERD – without incisions.

The procedure is performed endoscopically through the mouth, using a surgical device to form and fasten tissue folds to reconstruct the antireflux valve at the junction of the esophagus and stomach. The procedure is performed under general anesthesia and normally lasts 50-60 minutes.

TIF is for patients whose symptoms no longer respond to pharmaceutical therapies or are concerned about the long-term effects of daily use of reflux medications. Not everyone is a candidate for the procedure. Patients who have previously had stomach or esophagus surgery, or who have a large hiatal hernia may not be eligible for TIF.

Because there are no incisions, recovery time is shorter than traditional surgery. Patients follow a liquid diet and soft foods for about two weeks, and most are able to resume normal activities within a few days.

Traditional Treatments

GERD today is typically treated with medications such as histamine receptor antagonists (H2 blockers), such as Pepcid, Tagamet and Zantac, and proton pump inhibitors (PPIs), such as Nexium, Prilosec and Protonix. These medications can lose their effectiveness over time. They also don’t treat the underlying root causes of reflux, the deteriorated anatomy of the antireflux barrier, so life-long medication therapy is required. In addition, recent studies on the adverse effects of long-term use of PPIs indicate a significantly higher incidence of hip fractures, particularly among women.

Surgical Specialties

Our surgeons have specialized skills and knowledge in diverse areas. We are equipped to provide patients with the best options for comprehensive, state-of-the-art care.