nissen fundoplication

Hi cnotes,

Sorry, I've never heard of it. The doctor I saw for my heartburn and reflux prescribed a medication for it but I didn't have any further testing done for it. I did have a colonoscopy because I was having some bleeding with bowel movements.

Maybe someone else reading here may know about it.

Wishing you well,
Joanne

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I would like to hear from people who have had endoscopic procedures done to treat GERD. I have a feeling that I am going to have to do something, because PPI's are not helping enough. It is causing sinus infections and asthma. Someone sent me a private message, but it was not allowed to go through.

Please re read the forum rules and guidelines.

Ive just had that op done. What would you like to know?

mikido,
Glad the surgery went well, and you're doing great! This surgery appears rather extreme. Did the meds stop working for you? What was the primary reason the surgery was performed? Was it relfux or hiatal hernia, or both? Hiatal hernia seems to be mentioned quite a bit for with individuals who had the surgery.

Wishing you continued progress through the recovery process.


Vanessa

 I had a Nissen Fundiplication done in March 2004. I had fairly good results until in August (2005) I started having many GERD symptoms. The symptoms came back after helping my daughter with a move where I was very active, lifting boxes and so on.  My physician said he did not feel the activity should affect the Nissen but I can only report what I observed.

I've always heard that you can't vomit after the Nissen...what do her doctors say about this?

I don't think that the wrap could have been done properly if you were able to eat normally 12 hours after surgery. It was 36 hours before I was given anything to eat, and for very good reason, it took me over an hour to get 4 spoonfuls of porridge down.

2 weeks later, I'm still on a very much liquid diet and struggling to get enough fluids down.

Can anyone give me any advice on what I can eat to vary my diet - I'm going crazy on soup. Mashed potato, very overcooked macaroni cheese and scrambled eggs are possible to get down, but a long and painful process.

Has anyone else found it particularly difficult to swallow fluids? I'm very badly dehydrated any my skin's in a horrendous state.

Hope someone out there can help.

For those considering surgery, I would still recommend it. Once food is down, it stays down - something I haven't regularly experienced in over 10 years. The constant pain of acid wearing away at my gullet is gone. I'm just looking forward to being able to eat better.

Based on the after effects that I've heard, I am also reluctant.  I am going to try the Plicator procedure.  I am looking into the risks but it sounds pretty safe.

From what I read, the Nissan Fundo can result in it being hard to burp, vomit, and makes you feel bloated for quite some time.  It just sounds uncomfortable.

I have to say that I'm only 2 1/2 weeks in and there's no pain at all with my insides. The muscles have healed very well - I can move fairly freely, and the wounds on the outside are looking pretty good. In fact one of them is just a little scar already.

It is very difficult to swallow, but every few days I can manage something new, so it is recovering rapidly.

One thing that you should be prepared for if you decide to go ahead is that you might experience a fair amount of sharp pain in your chest or left shoulder for the day following surgery. Nobody warned me about this, but it is the result of having had air pumped into the abdomen to facilitate the surgery. This air is removed as far as possible, but little pockets may remain and can take a couple of days to completely disperse. You just need to persevere and take painkillers to get past it.

Having lived with GERD for many years, I don't regret the surgery.

Its funny how the people here are talking like the symptoms after the surgery far out way the good points. True I had shoulder pain, I didn't eat solids for nearly 2 months and I can't burp or vomit. I also seem to be one of the rare ones who swallows air but this can be sured by speech therapy which i haven't gotten around to. But in all honesty I'd do it again and again and again the relief from the constant burning, nausea and random vomitting is amazing. I feel like I have a new lease on life and i'm only 25. I had the surgery at 21 and by the time I had the surgery I was so miserable that my quality of life was definitely zero. I would highly reccommend this surgery to anyone who needs it. Sure the first week is uncomfy but as soon as you go your first week without burning it really is worth it.

Delz, again, thanks for your thoughts on this. And, for some people, yes, the good outweighs the bad...especially since the discomfort from the surgery will go away, but, if you don't get the procedure, the burning stays.

I guess everyone has to decide if they need the procedure bad enough...some people are willing to live with the burn.

Hi everyone!

This is my first time writing. I am going to have the surgery on Feb. 20 and honestly, I can't wait. I have been researching and the hardest thing to find out is what you can or can't eat and drink. The surgeon and the hospital said they would give me list after surgery. Great then I go to the grocery store on my way home! Sorry about the sarcasm. Any suggestions?

Suggestion would be to head to this topic

Part 3 of POST OP LAP NISSEN...Please continue to post!!!

The topic you just posted under dates back to 2003. The one above has part one starting in October 2007 and continuing up to today. You'll find links to Part 1 and 2 under Part 3. I think that among the group posting who have recently had the surgery and those that had it a few years ago, you'll be extremely well informed for the 20th.

Hello everyone
I have had 2 laparscopic nissen fundo done. (First in 1998 and next one in 2003) Well
after I had a catscan(for another concern) they found that I have another paraesophagal hiatal hernia. Went for a eval. & now they willhave to do the "open" method. Has anyone had this open one done before?
What was it like. I need to spend 4-5 days in the hospital and 4 or more weeks for recovery. I was told I should for an epudural before they knock me out, this will alleviate alot of pain when I awake. They explained things that could happen but have never happened while they did other open cases.
Any help would be greatly appreicated. Have a good day!

To all considering a Nissen Fundoplication,

I am a 21-year old female who had the surgery done in December 2008, and I just wanted to give my thoughts on the surgery to anyone looking into it. I realize this surgery does help a lot of people, but I personally regret having it. I unfortunately am one of the 60% of patients who have had to go back on proton-pump inhibitors after the surgery. This statistic, given to me by my new GI doctor, was unbeknownst to me - and I assume a lot of people who have had the surgery - until post-operation.

I had a hiatal hernia and was having heartburn that the daily highest doses of Protonix plus a handful of Rolaids couldn't touch. I thought this was going to be my saving light. I had the surgery and went off the Protonix a month after the procedure. I was doing great until a couple weeks later, the excruciating pain was back. I could not believe it. My surgeon was "shocked" as none of his patients had ever had recurring heartburn after the surgery. I went back on Protonix and started popping the Rolaids like candy; same old routine. I also started noticing I was having difficulty swallowing liquids.

I started seeing a new GI doctor and it was discovered I had very high pressure in my lower esophagus which was slightly fixed through dilatation of the esophagus. This is necessary after the surgery for a handful of patients. He also determined that, during the dilatation procedure, when the balloon used to dilate my esophagus was inflated, I (under sedation) freaked out, whereas it generally causes no discomfort for most patients. He concluded my body is innervated in a way that has made my esophagus hypersensitive. Basically, the smallest amount of acid that could still get to my esophagus beyond the wrap causes me the same heartburn discomfort as someone with a lot of acid coming up. This is the case for a number of people but it's hard to diagnose. His recommendation was to put me on low dose anti-depressants to try to gradually tame my nerves. I have yet to go on these meds.

Lasting effects I have experienced after the surgery include not having productive burps, cannot eat foods high in fiber (bloating, gas, extreme discomfort), and I cannot allow myself to get very full without hours of lingering discomfort. And as mentioned above, I still have heartburn and swallowing problems. These problems are bothersome but tolerable.

I know this is not the case for everyone, but my advice is definitely do your research before you have the surgery. My doctor informed me that many surgeons (if their mind is outside of their wallet) have stopped performing the surgery since it doesn't seem to work. Get second or third opinions, look on other forums for other patients' experiences, ask your surgeon for the names of people who have had the surgery done.

Hi Sewingqueen,
Welcome to Healing Well! So sorry you have experienced so many problems. I agree that anyone considering a fundoplication should research it throughly and get several opinions. On this site, there are lots of people who have had experience with the surgery, and some have had more than one. I do know that the surgery can be a problem, and a certain percentage of patients suffer side effects.

There are many very disturbing stories all over the internet--enough to scare anyone away from this procedure. I spent four years searching the web, looking for information to help me make an informed decision. The internet sources I searched out provided me with an overabundance of reasons not to go ahead with a surgical fix.

It is clear that pre-testing is crucial to ensuring that a patient will be helped by this surgery. Motility tests (manometry--tests the strength and effectiveness of your swallowing muscles, as well as the strength of the LES valve.), 24hr PH Monitor, Barium Swallow, and perhaps a stomach emptying study, are all tests that can spot problems that could complicate this surgery.

Choosing a skilled and experienced surgeon is also critical. A surgeon who does an overly tight wrap can create swallowing problems--especially in someone who has slipped through the testing cracks, and has a swallowing problem to begin with. Careful selection of a good candidate is most important. Don't rush your way towards surgery. Go to a good GI doc, and thoroughly explore all your options. Once you have a trusted specialist, it's likely that he/she will be able to recommend a surgeon who is skilled in the procedure. Then check that surgeon's credentials further.

This is not a procedure that any surgeon can perform. It is a very special one, that requires lots of experience and skill. It is good that many surgeons are no longer performing the surgery. Too many surgeons attempt it without having the prerequisite competency, and the results can be disastrous.

Anyone considering this surgery should make an appointment with one or more surgeons...ask lots of questions. Just because you meet with someone doesn't mean you have to go through with surgery. My family doctor recommend a surgeon, and I met with him/had tests done/was told I was a good candidate for the surgery. I was not ready to make that decision, so I went back to my GI doc, who looked at the results of the tests the other surgeon did, and ordered an additional test. After testing was done and we discussed the results, he suggested that I just go and talk to the surgeon...no rush...just discuss the procedure, and start to think about what I wanted to do. I ended up meeting with his recommended surgeon twice, and made the decision to go through with the surgery.

Keep in mind that many, many people have a Nissen Fundoplication and never enter any comments in a forum online. It's more likely that people who had bad outcomes will search the web for reasons for their suffering. Many, many successful surgeries happen, and you just don't hear about them. The more problems a person has with the outcome, the more likely you'll hear about his/her poor results.

It is too early for me to know if I'll be in the ranks of the successful, or unsuccessful procedures. I understand that I can not speak with any authority in that regard.

I do know that as an open procedure, this is a 50 year old surgical method, so it must have helped many people for it to have lasted this long.

Laproscopic Nissen Fundoplication has been around a much shorter time (approx. 10 years, I believe, but I may be off on that number). From what I've read, the move to laproscopic Nissens has been beneficial, in that fewer surgeons are qualified for to do non-invasive procedures, and it creates a situation where a few surgeons get lots more Nissen surgeries--which provides ample opportunites for developing skills necessary for successful outcomes.

So yes...it seems that there is a disproportionally large number of Nissen failure when you read forums such as these. If you go to surgical sites, though...read medical journal entries, you will find that the success rate is quite high. That doesn't solve the problem for people who have had poor outcomes, but it should create more confidence in someone making the decision to have this life-changing surgery.

To those who are reading these posts--don't let scary stories make up your mind for you. Do the work to find out if this procedure is right for you. Then make an informed decision and go with it. Best wishes to anyone trying to make this difficult decision.
Also...good luck to those who are struggling with surgeries that didn't work out the way you had hoped. I hope you all find solutions to your medical problems.

Sewingqueen, I hope you find some help for your problems.
Good luck!
Denise

Sewingqueen -
I am sorry your surgery hasn't helped you. I too had issues with my first Nissen, but that was my fault also for not doing my homework and making sure the surgeon was well qualified and had done lots of successful Nissens. My surgeon used the technique originally designed in the 50s and isn't a functional repair. It stopped the reflux, but wouldn't let food or liquids pass correctly. I searched out a very very good surgeon who specializes in this problem and things are wonderful now after my redo. No reflux and food goes down normally.
I seem to be agreeing with Denise a lot the last few months, but I believe she has posted some quality information here and I wish I would have had access to it my first go round. Again, I am sorry your surgery was not successful.

Take care,
Bill