what can go wrong with a Nissen?

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Veteran Member

Date Joined Oct 2009
Total Posts : 739
   Posted 1/27/2011 5:43 PM (GMT -6)   
Hi all,

I have read a few posts saying that the Nissen can actually make things worse. I am going to talk to my dr. soon about it, but want to get some advice regarding questions from you all. What types of problems can the surgery cause? Why is it a big deal that is isn't reversable? I mean, if it comes undone, its reversed itself, right?

I think I could live with a little bloating or what not as opposed to cancer inducing gerd :) Just my view, although maybe I am not taking something into account?

Elite Member

Date Joined Jul 2009
Total Posts : 14475
   Posted 1/27/2011 9:12 PM (GMT -6)   
Worse case- If you choose the wrong surgeon they can flub up anywhere: too tight, too loose, a kink in the way he sewed it, etc.
Because they detact the floppy part of your stomach from it's attachments to wrap it, it will remain floppy if undone. Also there's a risk of holes from the undone stitches.
Some people did not get all of the testing done and it caused a wrong diagnosis.
I've heard of people having the surgery and the doctor didn't do all of the testing and it caused problems for them like food getting stuck because of motility problems the doctor didn't know about them.

Veteran Member

Date Joined Oct 2009
Total Posts : 739
   Posted 1/27/2011 9:42 PM (GMT -6)   
what are all the tests that need to be done? How do I know the surgeon I am using is a great one? Thanks for any additional advice you may have on the subject.

Forum Moderator

Date Joined Feb 2009
Total Posts : 7188
   Posted 1/27/2011 10:53 PM (GMT -6)   
Hi acidrefluxman,

The tests that any good surgeon will require are:
barium swallow
manometry (tests swallowing coordination and strength, and strength of LES)
24hr PH monitor

As Joy said, finding the best possible surgeon is critical to the success of the surgery. (As a surgeon recently told me, it's also critical to have the right patient--that's determined by the above tests.)

When I had my surgery done, I depended upon the recommendation of my GI doc. I also double checked with friends in the medical field, and they concurred.

I am now in a new city, and have found here that there is one surgeon who "does all the Nissens". That would be the person I'd want to do mine.

I've heard a rule of thumb that the surgeon that you choose should have done at least 300+ Nissens. (The one in my city now has done 1000+)

Your best bet would be to call around to different GI offices and ask who they recommend. See if one name rises to the top.

This isn't a surgery to be taken lightly. You need to really need it--to be in a situation that is you can't continue to live with. It's not that the surgery is that bad...it's actually much easier to recover from that I ever imagined. It's just that you will have changes made to your GI tract that you'll have to accept.

You may not be able to burp or vomit (I can do both--vomiting isn't recommended, so those of us who've had this surgery always carry anti nausea drugs, just in case). If you have an overly tight wrap you'll have some trouble with bloating and gas--especially in the beginning. Sometimes certain things don't want to go through your wrap (For example, I have trouble with some pills. If I eat a lot of salad or raw veggies, my wrap gets irritated.)

You have to feel that the possibility of those inconveniences is worth it to you. I knew when I had the surgery that I would not be made "whole" again--I wouldn't have the GI tract I had as a teenager. I had realistic expectations, and do not sweat the little inconveniences. I had uncontrolled asthma caused by my reflux, and it was not a healthy situation. I am very glad I had the surgery and would have a redo without hesitation, should it be necessary.

This forum gave me the courage to go forward with the surgery. As you've seen, there are many posts on the internet that are frightening. I'm quite sure that those are people who did not have surgeons with sufficient experience doing their procedure.

People here were realistic and positive. Is it a perfect answer? Unfortunately, no. Is it the best answer? For most of us here, yes.

Good luck making your decision.
Stick around!

Veteran Member

Date Joined Oct 2009
Total Posts : 739
   Posted 1/28/2011 8:45 AM (GMT -6)   
thanks dencha.

I feel like I am in that situation. Even on PPI's I have GERD consistently throughout the day (and worse at night). I feel like without something very proactive like surgery Ill just get Barrets and associated risks (If I don't have it already)...

I am having a manometry, PH test, as we speak, and have had endoscopies in the past. I feel like my GI will tell me that I have strong reflux and may want to do another endoscopy (haven't had 1 in a year), and Ill bring up the issue of a Barium swallow. What does the Barium swallow show that the other 3 don't?

Thanks for the help. I feel lucky that I am the type of person that can live with changes and not sweat it...I could deal w/ bloating, etc...I just can't deal with constant reflux because I feel like long-term (or already) it is going to give me barrets and could ultimately be very dangerous, whereas bloating is just an inconvenience and I will gain so much in just peace of mind.

Do you need to have Barrets to get the surgery?


Elite Member

Date Joined Jul 2009
Total Posts : 14475
   Posted 1/28/2011 6:16 PM (GMT -6)   
When I had my barium swallow I was able to watch some of it. For me, it showed my reflux and how I swallow. I watched the barium go down to my LES and go back up to my windpipe and spill over the side into my lungs. It "bounced" two or three times (spilling over each time) and then went into my stomach. It also showed my lower valve to my intestines open up.

Veteran Member

Date Joined Jun 2008
Total Posts : 903
   Posted 1/29/2011 1:13 AM (GMT 0)   
Denise is right on the money and like Joy, I've watched my barium swallows, very interesting.
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