Expert GERD Treatment from a Johns Hopkins Fellowship-Trained Specialist
Acid reflux, or gastroesophageal reflux disease (GERD), affects millions each year, causing significant discomfort and increasing the risk for serious health complications. Lalezari Surgical in Los Angeles specializes in advanced reflux surgery options under the expert care of Dr. Sepehr Lalezari, MD, FACS, a fellowship-trained surgeon from Johns Hopkins Medicine with over eight years of specialized experience in minimally invasive upper gastrointestinal procedures. Dr. Lalezari’s comprehensive training and published research in enhanced recovery protocols provide patients with the most advanced surgical treatments designed to effectively manage and cure symptoms of reflux disease.
As a board-certified Fellow of the American College of Surgeons (FACS) with recognition as a Los Angeles Magazine “Top Doctor” (2021-2024) and SUPERDOCTORS “Rising Star” (2023-2025), Dr. Lalezari brings exceptional qualifications to reflux surgery. His fellowship training at Johns Hopkins Medicine provided extensive exposure to complex upper gastrointestinal procedures, including advanced laparoscopic anti-reflux operations, revision procedures, and emergency reflux-related surgeries. This specialized expertise ensures optimal outcomes for patients seeking lasting relief from GERD symptoms.
Understanding Reflux Disease and Its Impact
GERD occurs when stomach acid frequently flows back into the tube connecting your mouth and stomach (esophagus). This backwash (acid reflux) can irritate the lining of your esophagus, leading to significant discomfort and potential complications such as esophageal strictures, Barrett’s esophagus, and increased risk of esophageal cancer. Dr. Lalezari’s comprehensive understanding of GERD pathophysiology, gained through his specialized training and clinical experience, allows for optimal patient evaluation and treatment selection.
Comprehensive GERD Symptom Recognition
Common symptoms of GERD that Dr. Lalezari evaluates and treats include:
- Primary GERD Symptoms:
- Heartburn: A burning discomfort in the chest that often occurs after eating and worsens when lying down, bending over, or during physical activity
- Regurgitation: A sour or bitter-tasting acid backing up into your throat or mouth, particularly noticeable at night or when lying flat
- Difficulty Swallowing (Dysphagia): Sensation of food being stuck in your throat or chest, which may indicate esophageal narrowing or motility issues
- Chest Pain: Can occur particularly at night and may be severe enough to mimic cardiac symptoms
- Secondary GERD Symptoms:
- Chronic Cough: Persistent cough that doesn’t respond to typical treatments
- Hoarseness: Voice changes due to acid irritation of the vocal cords
- Asthma-like Symptoms: Wheezing and breathing difficulties triggered by acid reflux
- Dental Problems: Tooth enamel erosion from repeated acid exposure
- Sleep Disruption: Nighttime symptoms affecting quality of life and rest
- Complications Requiring Surgical Intervention:
- Esophageal Strictures: Narrowing of the esophagus due to chronic inflammation
- Barrett’s Esophagus: Pre-cancerous condition requiring ongoing surveillance
- Esophageal Ulcers: Deep tissue damage from prolonged acid exposure
- Respiratory Complications: Aspiration pneumonia and chronic lung problems
Advanced Reflux Surgery Options in Los Angeles
Lalezari Surgical offers a comprehensive range of surgical treatments tailored to the severity and specific characteristics of each patient’s reflux disease. Dr. Lalezari’s fellowship training and extensive experience ensure optimal procedure selection and surgical execution for lasting symptom relief.
- Treatment for GERD
Dr. Lalezari provides comprehensive GERD management including medication optimization, lifestyle modifications, and when necessary, advanced surgical intervention. His approach combines evidence-based medical management with surgical expertise to provide patients with the most effective treatment strategy.
Comprehensive GERD Evaluation Process:
- Detailed Symptom Assessment: Thorough evaluation of symptom severity, frequency, and impact on quality of life
- Advanced Diagnostic Testing: pH monitoring, esophageal manometry, and barium swallow studies
- Endoscopic Evaluation: Upper endoscopy to assess for complications and anatomical abnormalities
- Medical Optimization: Trial of proton pump inhibitors and lifestyle modifications when appropriate
- Surgical Candidacy Assessment: Determination of optimal timing and procedure selection
Medical Management Coordination:
- Collaboration with gastroenterologists for comprehensive care
- Optimization of anti-reflux medications prior to surgery
- Management of associated conditions like hiatal hernia
- Pre-operative preparation and risk assessment
- Nissen Fundoplication
The Nissen fundoplication is the gold standard surgical procedure that increases pressure at the lower end of the esophagus by wrapping the upper part of the stomach around the lower esophagus to create a competent anti-reflux valve. Dr. Lalezari’s advanced laparoscopic technique ensures optimal outcomes with minimal invasiveness.
Dr. Lalezari’s Advanced Nissen Technique:
- Complete Short Gastric Division: Ensures tension-free wrap construction
- Precise Wrap Geometry: Optimal length and tightness for effective reflux control
- Crural Repair: Reinforcement of the diaphragmatic opening when hiatal hernia is present
- Intraoperative Endoscopy: Quality assurance for optimal wrap positioning
Laparoscopic Advantages:
- Minimally Invasive Approach: Five small incisions instead of large abdominal incision
- Faster Recovery: Most patients discharged the same day or after overnight observation
- Reduced Pain: Significantly less post-operative discomfort compared to open surgery
- Superior Visualization: High-definition laparoscopic imaging for precise surgical technique
- Lower Complication Rates: Reduced risk of wound infection and hernia formation
Expected Outcomes:
- Over 90% of patients experience complete resolution of heartburn symptoms
- Significant improvement in regurgitation and other GERD symptoms
- Long-term durability with excellent patient satisfaction rates
- Ability to discontinue or significantly reduce acid-suppressing medications
Post-Operative Care Protocol:
- Progressive dietary advancement over 4-6 weeks
- Regular follow-up appointments to monitor healing and symptom resolution
- Long-term surveillance for wrap integrity and symptom control
- Patient education on dietary modifications and lifestyle optimization
- LINX Procedure
The LINX procedure is a minimally invasive surgery where a ring of tiny magnetic beads is wrapped around the junction of the stomach and esophagus to augment the lower esophageal sphincter, preventing reflux while allowing normal swallowing and belching. Dr. Lalezari’s expertise in this innovative procedure provides patients with an advanced alternative to traditional anti-reflux surgery.
LINX Device Technology:
- Magnetic Sphincter Augmentation: Titanium beads with magnetic cores that open and close with swallowing
- Preserved Anatomy: No anatomical alteration or stomach manipulation required
- Reversible Procedure: Device can be removed if necessary, restoring normal anatomy
- MRI Conditional: Safe for MRI imaging with specific protocols
Dr. Lalezari’s LINX Expertise:
- Precise Sizing: Optimal device selection based on esophageal measurements
- Advanced Laparoscopic Technique: Minimally invasive placement with excellent visualization
- Comprehensive Pre-operative Evaluation: Careful patient selection for optimal outcomes
- Long-term Follow-up: Ongoing monitoring for device function and symptom control
Ideal LINX Candidates:
- Patients with typical GERD symptoms and proven acid reflux
- Normal esophageal motility on pre-operative testing
- Absence of large hiatal hernia (greater than 3 cm)
- Desire to avoid permanent anatomical alteration
- Failed medical management with persistent symptoms
Clinical Advantages:
- Immediate Reflux Control: Prevention of acid reflux from day one
- Preserved Belching and Vomiting: Maintenance of natural protective mechanisms
- No Gas-Bloat Syndrome: Avoidance of common fundoplication side effects
- Quick Recovery: Most patients return to normal activities within a week
- Long-term Effectiveness: Sustained symptom relief with excellent durability
Specialized Anti-Reflux Procedures
- Partial Fundoplication Options
For patients with specific anatomical or functional considerations, Dr. Lalezari offers tailored partial wrap procedures:
- Toupet Fundoplication: 270-degree posterior wrap for patients with impaired esophageal motility
- Hill Procedure: Anatomical repair focusing on the angle of His restoration
- Dor Fundoplication: 180-degree anterior wrap used primarily with myotomy procedures
- Revision Anti-Reflux Surgery
Dr. Lalezari’s expertise includes complex revision procedures for failed previous operations:
- Wrap Revision: Correction of loose, tight, or migrated fundoplication wraps
- Hiatal Hernia Repair: Management of recurrent hiatal hernias after initial surgery
- LINX to Fundoplication Conversion: When magnetic sphincter augmentation requires revision
- Fundoplication to LINX Conversion: Alternative approach for failed traditional surgery
- Complex Reflux Cases
Dr. Lalezari’s fellowship training and experience include management of challenging presentations:
- Giant Hiatal Hernias: Large hernias with significant anatomical distortion
- Short Esophagus: Complex cases requiring esophageal lengthening procedures
- Barrett’s Esophagus: Anti-reflux surgery for patients with pre-cancerous changes
- Failed Medical Management: Patients with medication intolerance or inadequate control
Why Choose Dr. Lalezari for Reflux Surgery?
- Exceptional Training and Expertise
Opting for reflux surgery at Lalezari Surgical provides patients with access to one of Los Angeles’ most qualified specialists:
- Johns Hopkins Fellowship Training: One of the world’s premier programs for advanced laparoscopic surgery
- Board Certification: Fellow of the American College of Surgeons (FACS)
- Specialized Experience: Over eight years of dedicated upper GI and anti-reflux surgery
- Published Research: Peer-reviewed articles in enhanced recovery protocols and surgical outcomes
- Professional Recognition: Los Angeles Magazine “Top Doctor” and SUPERDOCTORS awards
- Advanced Minimally Invasive Capabilities
Dr. Lalezari focuses on minimally invasive procedures that provide superior outcomes:
- Reduced Recovery Time: Faster return to normal activities and work
- Minimized Surgical Trauma: Smaller incisions with less pain and scarring
- Lower Risk Profile: Decreased complications compared to traditional open surgery
- Enhanced Precision: Advanced laparoscopic visualization and instrumentation
- Same-Day Surgery Options: Many procedures allow discharge the same day
- Comprehensive Personalized Care
Dr. Lalezari offers individualized treatment plans based on thorough patient assessments:
- Detailed Pre-operative Evaluation: Comprehensive testing to optimize procedure selection
- Patient Education: Thorough explanation of conditions, treatment options, and expectations
- Multidisciplinary Coordination: Integration with gastroenterologists and other specialists
- Long-term Follow-up: Continued care and monitoring for sustained symptom relief
- Quality of Life Focus: Treatment approaches designed to restore normal daily activities
- State-of-the-Art Technology and Innovation
- Advanced Laparoscopic Equipment: High-definition imaging and precision instruments
- LINX Technology: Access to the latest magnetic sphincter augmentation device
- Enhanced Recovery Protocols: Evidence-based approaches to optimize healing
- Comprehensive Diagnostic Capabilities: In-house testing for complete evaluation
What to Expect with Reflux Surgery
- Comprehensive Pre-Surgery Evaluation
Dr. Lalezari conducts thorough diagnostic evaluations to accurately diagnose GERD and tailor treatment plans for optimal outcomes.
Advanced Diagnostic Testing:
- Upper Endoscopy: Direct visualization of the esophagus and stomach to assess for complications
- 24-Hour pH Monitoring: Quantitative measurement of acid reflux episodes
- Esophageal Manometry: Assessment of esophageal muscle function and coordination
- Barium Swallow Study: Evaluation of swallowing function and anatomical abnormalities
- CT Scan: Assessment of hiatal hernia size and anatomical relationships
Pre-operative Optimization:
- Medical Condition Management: Optimization of diabetes, hypertension, and other conditions
- Nutritional Assessment: Evaluation and correction of nutritional deficiencies
- Weight Management: Counseling and support for optimal surgical outcomes
- Smoking Cessation: Programs to improve healing and reduce complications
- Patient Education: Comprehensive preparation for surgery and recovery
- Expert Surgical Execution
Depending on the chosen procedure, Dr. Lalezari’s surgery typically lasts between one to three hours under general anesthesia, utilizing advanced minimally invasive laparoscopic methods for optimal outcomes.
Surgical Excellence Standards:
- Advanced Laparoscopic Techniques: State-of-the-art equipment and instrumentation
- Quality Assurance Protocols: Systematic approach to surgical excellence
- Intraoperative Monitoring: Real-time assessment of patient status and surgical progress
- Team-Based Approach: Experienced surgical team dedicated to optimal outcomes
- Safety Focus: Comprehensive protocols to minimize risks and complications
Procedure-Specific Techniques:
- Fundoplication: Precise wrap construction with attention to geometry and tension
- LINX Placement: Accurate sizing and positioning for optimal function
- Hiatal Hernia Repair: Comprehensive crural repair and mesh reinforcement when indicated
- Quality Control: Intraoperative testing to ensure optimal anti-reflux mechanism
- Comprehensive Post-Surgery Care and Recovery
Recovery varies by procedure, but most patients can expect to return to normal activities within a few weeks. Dr. Lalezari’s comprehensive post-operative care ensures optimal healing and long-term success.
Immediate Post-operative Care:
- Pain Management: Advanced multimodal approaches for patient comfort
- Early Mobilization: Protocols to prevent complications and promote healing
- Dietary Progression: Structured advancement from liquids to solid foods
- Monitoring and Assessment: Regular evaluation of healing and symptom resolution
- Patient Education: Comprehensive instructions for optimal recovery
Long-term Recovery Support:
- Follow-up Appointments: Scheduled visits at 2 weeks, 3 months, 6 months, and annually
- Dietary Counseling: Nutritionist consultation for optimal eating strategies
- Symptom Monitoring: Assessment of reflux control and functional outcomes
- Quality of Life Evaluation: Measurement of treatment success and patient satisfaction
- Long-term Surveillance: Ongoing monitoring for sustained effectiveness
Dietary Adjustments and Guidelines:
- Progressive Diet Advancement: Gradual return to normal foods over 4-6 weeks
- Portion Control: Smaller, more frequent meals to optimize comfort
- Food Texture Modifications: Temporary adjustments to accommodate healing
- Hydration Strategies: Optimal fluid intake timing and quantity
- Long-term Dietary Optimization: Strategies to maintain symptom control
Advanced Reflux Management Strategies
- Enhanced Recovery After Surgery (ERAS) Protocols
Dr. Lalezari implements evidence-based ERAS protocols for optimal outcomes:
- Pre-operative Preparation: Nutritional optimization and patient education
- Intraoperative Excellence: Advanced anesthesia protocols and surgical techniques
- Post-operative Care: Multimodal pain management and early mobilization
- Accelerated Recovery: Faster return to normal activities and improved satisfaction
- Long-term Success Strategies
- Patient Education: Comprehensive understanding of post-operative care
- Lifestyle Modifications: Dietary and behavioral changes to optimize outcomes
- Regular Monitoring: Ongoing assessment of symptom control and quality of life
- Preventive Care: Strategies to maintain long-term surgical success
- Complication Prevention and Management
- Risk Assessment: Pre-operative identification and management of risk factors
- Surgical Excellence: Advanced techniques to minimize complications
- Early Detection: Prompt identification and treatment of any issues
- Comprehensive Management: Expert care for any post-operative concerns
Frequently Asked Questions About Reflux Surgery
Dr. Lalezari's comprehensive evaluation considers symptom severity, response to medical treatment, diagnostic test results, and impact on quality of life to determine surgical candidacy.
Nissen fundoplication creates a stomach wrap around the esophagus, while LINX uses magnetic beads to augment the natural sphincter. Both are effective, with selection based on individual patient factors and preferences.
Both procedures provide excellent long-term results. Nissen fundoplication has decades of follow-up data showing durable outcomes, while LINX studies demonstrate sustained effectiveness at 5+ years.
Most patients return to a normal diet within 4-6 weeks. Some temporary modifications may be needed initially, but long-term dietary restrictions are minimal.
Yes, both procedures can be reversed if necessary. LINX can be removed laparoscopically, and fundoplication can be taken down, though this is rarely required.
While complications are rare with Dr. Lalezari's advanced techniques, risks include bleeding, infection, and temporary swallowing difficulties. Specific risks are discussed during consultation.
Schedule a Consultation for Acid Reflux Surgery in Los Angeles
If you are suffering from persistent GERD symptoms and seeking long-term relief under the care of a fellowship-trained specialist, contact Lalezari Surgical today to schedule a consultation with Dr. Lalezari. Discover how our advanced reflux disease treatments in Los Angeles can dramatically improve your quality of life and provide lasting symptom relief.
Why Choose Dr. Lalezari for Reflux Surgery:
- Fellowship training from Johns Hopkins Medicine in advanced laparoscopic techniques
- Board-certified FACS with 8+ years of specialized reflux surgery experience
- Published researcher in enhanced recovery protocols and surgical outcomes
- Los Angeles Magazine “Top Doctor” and SUPERDOCTORS recognition
- Access to the most advanced procedures including LINX and robotic surgery
- Comprehensive approach from evaluation through long-term follow-up
What to Expect During Your Consultation:
- Personal evaluation by Dr. Lalezari with comprehensive GERD assessment
- Review of diagnostic studies and symptom impact on quality of life
- Discussion of all available treatment options including surgical and non-surgical
- Realistic outcome expectations and individualized risk assessment
- Development of personalized treatment plan
- Insurance verification and financial counseling
Dr. Sepehr Lalezari is a board-certified reflux surgeon with fellowship training from Johns Hopkins Medicine. Individual results may vary. This information is for educational purposes and does not replace professional medical advice. Always consult with Dr. Lalezari or a qualified healthcare provider for personalized medical guidance.
