Foregut revision surgery is performed to correct or improve the results of a previous anti-reflux, hiatal hernia, or foregut procedure. Patients may experience recurrent reflux, persistent symptoms, anatomical failure, wrap disruption, slipped fundoplication, recurrent hiatal hernia, or complications from prior surgery. Revision surgery restores proper anatomy, improves symptoms, and provides durable long-term relief.

Revision surgery addresses issues such as failed fundoplication, recurrent hernia, disrupted wrap, tight or loose wrap, slipped stomach, or complications from prior LINX or foregut procedures. The surgeon evaluates scar tissue, restores anatomy, repairs the hiatus, and reconstructs or modifies the anti-reflux mechanism. Options include redo Nissen, conversion to Toupet or Dor, removal or replacement of LINX, or conversion to gastric bypass in selected cases.

Improved reflux control. Relief of regurgitation and chest discomfort. Better swallowing. Correction of anatomical failure. Treatment of complications from prior surgery. Restoration of foregut function. Minimally invasive approach in most cases.

Patients with recurrent GERD after prior surgery. Patients with slipped or disrupted fundoplication. Patients with recurrent hiatal or paraesophageal hernia. Patients with dysphagia from a tight wrap. Patients with complications from LINX or prior foregut procedures. Patients with objective evidence of failure on imaging or endoscopy.

The procedure is performed laparoscopically or robotically. Scar tissue is carefully dissected. The stomach and esophagus are mobilized. The hiatal hernia is repaired if present. The prior wrap is taken down and reconstructed as Nissen, Toupet, or Dor depending on anatomy and motility. LINX devices may be removed or replaced. In selected cases, conversion to gastric bypass is performed for severe reflux or obesity.

Revision surgery carries higher complexity due to scar tissue. Risks include bleeding, infection, esophageal injury, or recurrence. Temporary swallowing difficulty may occur. Patients with severe motility disorders may require partial wraps or alternative procedures.

Timeline Most patients go home the same day or next day. Light activity is resumed within a few days. Soft diet for one to two weeks. Full recovery typically occurs within two to four weeks. Swallowing improves gradually as swelling resolves.

Most patients experience significant improvement in reflux, swallowing, and quality of life. Revision surgery provides durable results when combined with proper patient selection, anatomical correction, and long-term follow-up.

Dr. de la Cruz-Muñoz is a nationally recognized bariatric, metabolic, and foregut surgeon with extensive experience in complex revision surgery, including redo fundoplication, recurrent hernia repair, LINX removal, and conversion procedures. His expertise ensures safe, durable outcomes for patients with challenging foregut anatomy. Our practice provides bilingual care for patients from Miami, Puerto Rico, the Dominican Republic, and Latin America.