Nissen fundoplication is a procedure done to help children who have gastroesophageal reflux disease (GERD). Sometimes the surgeon also places a gastrostomy tube (G-tube) for nutrition into the child's stomach. Follow these instructions to help your child heal after their surgery.

• Let your child rest as needed.
• Follow the instructions from the care team about feeding your child.
• Give your child all medicines as directed by your health care provider.
• Remove the bandages as directed. Allow the wound closure strips to fall off on their own. Watch for signs of infection, such as redness, swelling, or pus.
• If your child has a G-tube:
  • Follow instructions about when it is OK to use it. 
  • Keep the area around the G-tube clean with soap and water. 
  • Kids should have sponge baths until the health care provider says it's OK to take a bath or shower.
  • No soaking in water or swimming until the doctor says it's OK.
• Schedule a follow-up visit with your child's surgeon as directed.

• Your child develops a fever, swollen belly, or severe retching (dry heaving).
• Your child has problems eating or swallowing.
• You notice redness, swelling, or pus at the incisions.
• You're concerned that the G-tube has fallen out or isn't working properly.
• Your child's pain is severe or isn't helped by pain medicine.
• Your child has a cough, fast breathing, diarrhea, or constipation.
• Your child's reflux symptoms return, or your child vomits.
• You have any other questions or concerns.

• Your child is wheezing, feels short of breath, or has trouble breathing.
• Your child shows signs of dehydration (not enough water in the body), such as a dry, sticky mouth; increased thirst; peeing less often than usual; dark pee; or crying with little or no tears.
• You're concerned that the G-tube has fallen out or isn't working properly and you can't reach your health care provider.

What happens during Nissen fundoplication? The child gets anesthesia medicines to sleep during the surgery and not feel pain. Then, the surgeon wraps the top part of the stomach around the lower esophagus.

How does Nissen fundoplication help with GERD? After the procedure, the lower esophagus is tighter, which prevents the stomach's acid and contents from coming up into the esophagus.