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.
My symptoms were bad enough that I was considering a redo of the Nissen. My GI doc did an endoscopy and said the wrap was 'flapping in the wind' to indicate it was loose. I had a subsequent Bravo (implanted pH monitor placed by endoscopy that falls off after a few days and is passed in the stool) test (which requires another endoscropy) and the physician who did the Bravo placement noted the wrap was loose and likely to cause reflux symptoms.
I contacted a surgeon who insisted on doing his own endoscopy before surgery and he found the wrap intact and firm enough such that he didn't expect me to have symptoms. The Bravo test came back negative (not enough acid to warrant surgery) and I noted during the test that I was remarkably free of GERD symptoms during the test.
I'm confident I was having severe GERD symptoms with regurgitation and so on. I
believe things have improved since things got noticeably worse in August 2005. The docs all claim there is no explanation for why my symptoms would get worse then better. I'm now getting the impression they think I'm a bit psycho; I'm convinced that the docs think anyone who can't be easily diagnosed must be imagining their symptoms. My brother, the doctor (professor of medicine), claims I'm caught in a diagnostic dilemma. I suppose things will have to get much worse before I'll definitely need a redo of the Nissen. For now I'm doing just Ok, some symptoms but evidently not severe enough to warrant a redo of the Nissen.
I'm happy to be able to avoid the surgery but am uncertain on the status of my wrap.
I do think my wrap was compromised in the first weeks after the srugery due to some bad advice by my surgeon. The surgeon who did my first wrap does many Nissens and is affiliated with a major university medical center. He claimed I could eat a normal diet immediately after the surgery and that for the first week after surgery I should 'not play rugby'. The surgeon I consulted about the redo is also associated with a major university medical center, has practice that is 99% devoted to GERD, and claims his protocol for post surgery is much different. After my first surgery I am reasonably certain that by eating normal foods starting 12 hours after my surgery (while still in the hospital) and being more active and lifting more than was wise (but I didn't play rugby) that I compromised my wrap.
It is my belief that I wouldn't be having the problems I'm having now if I had been more careful with diet and activity in the weeks following my surgery.
Overall I think the surgery was a good thing and blame the early failure on what I have done to myself, albeit, following doctor's orders. If medically indicated I would have the procedure redone.
Hope this helps.