Dr. Raffaele Galli offers specialised surgical care for conditions of the upper gastrointestinal tract, such as:

gastroesophageal reflux disease (GERD)
hiatal hernias
achalasia
gastric ulcers and other stomach diseases
gastric cancer

Most procedures are performed using minimally invasive techniques, allowing for smaller incisions, reduced pain, and a quicker recovery. Depending on the type of surgery, the hospital stay typically ranges from a few days up to one week.

Dr. Raffaele Galli will guide you through the diagnostic work-up and any conservative treatments, working closely with gastroenterologists and oncologists to provide a fully coordinated and comprehensive approach to your care.

Antireflux and Gastric Surgery

Frequently asked questions

Who is a candidate for antireflux surgery?

Candidates for antireflux surgery are typically patients with chronic gastroesophageal reflux disease (GERD) with persistent reflux symptoms such as severe or frequent heartburn, regurgitation, or chest discomfort interfering with daily life despite optimal medical treatment (antacids), patients with a large hiatal hernia, and patients with dependence on long-term medication who prefer a surgical solution (especially young patients).

Which diagnostic tests are required before surgery for reflux?

According to international guidelines, several tests may be needed to confirm the diagnosis of reflux disease before considering surgery:

Gastroscopy (endoscopy): This examines the esophagus and stomach to look for visible signs of reflux, such as inflammation or complications like Barrett’s esophagus.
pH or pH-impedance monitoring: This test measures acid and non-acid reflux episodes over 24–48 hours. It provides objective proof of reflux and is essential when symptoms are unclear. Results are interpreted using the Lyon criteria to determine whether reflux is truly abnormal.
Esophageal manometry: This test evaluates the function of the esophageal muscles and the lower esophageal sphincter. It is required before surgery to rule out motility disorders and ensure that an antireflux procedure will be safe and effective.
Contrast swallow (barium swallow): This X-ray study helps visualize a hiatal hernia, assess swallowing dynamics, and detect reflux.

Together, these tests ensure an accurate diagnosis and help tailor the best possible treatment plan, including whether surgery is appropriate.

Is surgery always necessary for a hiatal hernia?

Small (<2-3 cm) hiatal hernias without symptoms do not require surgical treatment. However, in patients with reflux or larger hernias, surgery may be necessary.