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At UPMC Children's Hospital of Pittsburgh, we believe parents and guardians can contribute to the success of this surgery and invite you to participate. Please read the following information to learn about the surgery and how you can help.
Normally, stomach contents and acid are stopped from coming back up into the esophagus (es-SOF-uh-gus) by a muscle at the bottom of the esophagus. When this muscle doesn’t work properly, the contents of the stomach flow back into the esophagus. The backward flow is called “reflux.”
If uncorrected, the acid can harm the lining of the esophagus by causing ulcers, scars or bleeding. The stomach contents also can come up the esophagus and enter the lungs. This is called “aspiration” (as-per-A-shun) and can cause cough, airway irritation or even pneumonia.
In most cases, reflux can be treated with medication taken by mouth; but for those children whose symptoms have not improved with medication, surgery is recommended.
The gastroesophogeal (GAS-tro-ee-sof-uh-JEE-ul) repair surgery is often referred to as a “wrap” because the upper portion of the stomach is wrapped around the lower portion of the esophagus. The wrap tightens or narrows the opening of the esophagus as it enters into the stomach. After the surgery, the wrap keeps food and fluids from backing up into the esophagus from the stomach.
This surgery is done under general anesthesia. General anesthesia makes your child’s whole body go to sleep and is needed for this surgery so that his or her reflexes will be completely relaxed. General anesthesia makes the surgery easier and safer to do because your child will not feel any pain or have any memory of the surgery.
Once the decision for surgical treatment is made, your doctor may need your child to have a few tests to make sure that the surgery is right for your child. Your child’s doctor may order:
These tests are done through the Gastroenterology Department at Children’s.
Once your child has been registered, he or she will be taken to a “holding area” where you will meet the anesthesiologist and your surgeon. A pediatric anesthesiologist—a doctor who specializes in anesthesia for children—will give the medications that will make your child sleep during the surgery. At this time, you will be able to ask any questions about the procedure.
Once questions are answered and the operating room is prepared, your child will be taken into the operating room and given an anesthetic to make him or her go to sleep.
When your child is asleep, the surgery will begin. If using the laparoscopic (lap-a-ro-SKOPP-ic) technique:
If the surgery is done using an “open” procedure, an incision is made in the upper abdomen.
When general anesthesia is needed, there are important rules for eating and drinking that must be followed in the hours before the surgery. One business day before your child’s surgery, you will receive a phone call from a nurse between the hours of 1 and 9 p.m. (Nurses do not make these calls on weekends or holidays.) Please have paper and a pen ready to write down these important instructions.
For children older than 12 months:
For infants under 12 months:
For all children:
Before the surgery, a member of the anesthesia staff will meet with you to take your child’s vital signs, weight and medical history. As the parent or legal guardian, you will be asked to sign a consent form before the anesthesia is given.
While your child is asleep, his or her heart rate, blood pressure, temperature and blood oxygen level will be checked continuously.
When your child is moved to the recovery room, you will be called so that you can be there as he or she wakes up.
The most important role of a parent or guardian is to help your child stay calm and relaxed before the surgery. The best way to help your child stay calm is for you to stay calm.
Your child will have an IV for getting pain medication for as long as he or she needs it after the surgery (usually about 1 day for the laparoscopic procedure and 2 to 3 days for the open procedure). After this time, your child will be prescribed a pain medication to be taken by mouth.
While in the hospital, your child will be encouraged to get out of bed by the next day.
If your child had the laparoscopic procedure, he or she will have Steri-StripsTM covering the small incisions. Steri-Strips are adhesive strips that are sometimes used on shallow cuts instead of stitches to hold the edges of the cut together. They will dry up and fall off on their own as the incision heals.
If your child had an open procedure, he or she may have Steri-Strips covered by a gauze bandage or dressing over the incision. This dressing will be changed during your child’s hospital stay. You will be given instructions on how to care for the dressing when your child leaves the hospital. The Steri-Strips will fall off on their own as the incision heals.
If your child comes home with a gastrostomy tube, you will be given instructions on how to care for it before leaving the hospital.
After the surgery, there will be a mild swelling of the wrap while the surgery heals. This swelling should go down within 2 weeks. Your child should have mostly liquids for the first 2 weeks after surgery.
Your child also should avoid eating certain foods.
After the laparoscopic procedure, your child may go back to normal activity in about 1 to 2 weeks. After an open procedure, your child may go back to normal activity in about 2 to 3 weeks. At this time, your child may return to school. He or she may go back to gym class after the follow-up visit with your surgeon, usually about 2 to 4 weeks after the surgery.
You may call the office at any time with questions regarding your child’s procedure. You should call right away if:
If you have any specific questions about your child’s surgery, you should discuss them with the surgeon before the surgery. You may call the Division of Pediatric Surgery at Children’s and ask to speak with your child’s surgeon, or speak with him or her during the pre-surgical examination on the day of the surgery.
If your child has any special needs or health issues you feel the doctor needs to know about, please call the Division of Pediatric Surgery at Children’s before the surgery and ask to speak with a nurse. It is important to notify us in advance about any special needs your child might have.
Division of Pediatric Surgery
UPMC Children's Hospital of Pittsburgh
One Children’s Hospital Drive
4401 Penn Ave.
Pittsburgh, PA 15224
Children's Hospital's main campus is located in the Lawrenceville neighborhood. Our main hospital address is:
UPMC Children’s Hospital of Pittsburgh
One Children’s Hospital Way
4401 Penn Ave.
Pittsburgh, PA 15224
In addition to the main hospital, Children's has many convenient locations in other neighborhoods throughout the greater Pittsburgh region.
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