Does anyone know the life span for a Nissen Fundoplication is?

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george559
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Date Joined Jan 2012
Total Posts : 28
   Posted 1/13/2012 11:49 AM (GMT -6)   
Just wanted to do a little research about the GERD surgery. How long does a Nissen Fundoplication surgery hold up?

bowecho
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Date Joined Nov 2011
Total Posts : 146
   Posted 1/13/2012 11:55 AM (GMT -6)   
You will find a lot of data on this around with different numbers. It really comes down to the skill and experience of the surgeon it seems.

My surgeon told me that there is no reason a properly done Nissen should come undone. Some of the studies I've found online track people for only up to 10 years, but still find high success rates at the 10 year mark.

We have a family friend that had the surgery a little over 20 years ago and is doing great.

Its just really tough to say. The best thing you can do is find an excellent surgeon and then take care of yourself after surgery.

Tony

george559
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   Posted 1/13/2012 11:59 AM (GMT -6)   
Would you happen to know about how much a laparascopic Nissen Fundo cost total?

bowecho
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   Posted 1/13/2012 12:07 PM (GMT -6)   
It will depend on what your insurance covers, I am not sure how much the procedure cost overall (probably somewhere in an insurance statement I have). I had to pay a $200 co-pay for the overnight hospital stay, the surgery itself was covered. I'd recommend contacting your insurance company, that's what I did before the surgery to make sure I knew what to expect.

Tony

bcfromfl
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   Posted 1/13/2012 12:07 PM (GMT -6)   
There was just a thread on this...it's on the second page now.

-Bruce

george559
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   Posted 1/13/2012 12:19 PM (GMT -6)   
The problem is I have medic-aid and medi-cal. I dont know if I will get a good surgen if I went along with it. I would probably have to use my medicaid part and pay 20% of what the total for surgery is for a very good sugen here where I live. I am just going to ask my family for help. I am just preparing my self if that is what I need.

bcfromfl
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   Posted 1/13/2012 12:23 PM (GMT -6)   
With the competition today for medical services, the cost would be the same whether you had an inexperienced surgeon or a good one.

-Bruce

george559
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   Posted 1/13/2012 12:28 PM (GMT -6)   
Very true thanks Bruce.

speedygerd
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   Posted 1/14/2012 12:58 AM (GMT -6)   
I've been wondering the same thing, especially since I'm young and I don't want to have multiple redo's throughout my life. Each time they go back in to fix you there is more internal scarring and adhesions, and the possibility for complications increases.

I suspect a lot of making a fundoplication last has to do with an individuals behavior and how well they take care of it immediately after the procedure and in the long run. I've read several articles on the subject and it appears one of the biggest risks to a solid fundoplication is weight lifting! No surprise there I guess, but unfortunate nonetheless (as it's something I like to do)

Here's some articles I've read that had interesting coverage of the subject:

http://www.medscape.com/viewarticle/540684
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1420811/
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1357166/
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1420908/

KITW
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   Posted 1/19/2012 10:19 PM (GMT -6)   
I have Barretts Disease, and had a full nissen fundoplication done 6 years ago. The first one was laproscopic, and it tore free after 19 days with a huge burp of gas.

I then had to undergo a full cut-open surgery from breastbone to belly button to repair it. It was awful and I think I wanted to just die rather than deal with it. But I survived and slowly got around to eating small amounts of food after 3-4 months. Carbohydrates are the easiest to digest like noodles, potatoes, and soft breads and crackers. Stringy meats like roast beef, turkey and pork give me the most trouble. Popcorn is a real killer!

Adhesions gave me trouble the first year, like rubber bands snapping inside of me, but the belly was always bloated and sore and felt like I am sunburned on the inside.

I have struggled with severe gastic backed up gas pains from time to time, and sometimes needing ER visits to get a purple cocktail (antacid and lidocane) and get on a morphine IV till it settles down after 4-5 hours again. this happens about every 2-3 months. I take daily PPI drug (Aciphex) and also Hyoscamine tablets under the tongue to help with pains.

Digestion is a mess. Either total diarrhea or backed up. Never normal (till just recently- more on that later) Not able to digest foods properly, unable to burp, unable to vomit, and no relief from gasses backed up and have to watch diet very carefully.

New gastro doc at 4 years ago said he would have NEVER had me do the Nissen, instead would have treated just with PPI drugs and scopings to watch progress.

3 years ago I slipped and fell on my stomach on a step, and it slipped about half the stomach above and half below, kinda hourglass shaped. It allows me to burp some now, still on the Aciphex. Less traumatic visits to the ER now.

Then about a year ago I discovered Beano... yes, that over the counter natural product to reduce gas. WHAT A LIFESAVER! It has helped me SO MUCH on the gastric distress, that I have not been to the ER in a year!!!

But I have still suffered for five years of acid filled diarrhea or blocked up bowels... feast or famine.

(2 years ago my body started growing uterine tumors so had a full hysterectomy too...this is where the story gets interesting)

Last month I had my gyno doc tell me to start going off my HRT - Hormone Replacement Patches slowly and start replacing with a Woman's multivitamin pill that also has included in it Black Cohash, Soy Isoflavones, Cinnamon and Cranberry Extract called "Menopause Support" available at CVS. Why am I telling you this? Because for the last three weeks I have been taking it, all my stools have returned to NORMAL!!!

It's like I want to dance and move and twist and shout. My belly don't hurt, I am not bloated, I feel NORMAL inside again for the first time in 6 years of dealing with this. I can bend over and sit on the floor with the grandkids and lean over and not feel pains inside!


I am a 51 year old active female who expects to live a long long life!

dawn.s
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   Posted 7/10/2012 3:31 PM (GMT -6)   
Hi, I am a 44 yr old aussie, i have had 3 laproscopic nissen's, all 3 have failed again i suffer severe gerd.. off to see gastroenterologist next wednesday..

buzzmoz
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Date Joined Mar 2012
Total Posts : 52
   Posted 7/10/2012 8:10 PM (GMT -6)   
Hi Dawn
Sounds like you are having a terrible run. Did the same surgeon do all of your wraps? Did you have the full 360 wrap or only partial?
Regards Buzz

JohnnnyRebel
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Date Joined Aug 2013
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   Posted 8/13/2013 2:29 AM (GMT -6)   
The key in obtaining a long-lasting result is based of two postulates:
1.) correct selection the appropriate candidate for LNF surgery
2.) correct selection of the experienced and skilled surgeon proficient in laparoscopic surgery and bariatrics

Bad surgeons and/or inappropriate patients can lead to bad results.

I had LNF surgery 15 years ago with excellent results - no more acid reflux and zero heartburn at any time. I was a good candidate in that my LES muscle was weak and not closing fully. I had no other issues.

My surgeon was highly skilled and performed a "Classic Nissen Fundoplication" (not the floppy), with 6 centimeters of wrap, anchored to the cardia. My "heavy-duty" valve should last the rest of my life-time. By the way, I lift weights on a routine basis with no detrimental effects concerning my Nissen wrap.

hopegood
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Total Posts : 93
   Posted 8/13/2013 8:36 AM (GMT -6)   
Hi JohnnnyRebel, are you in US? May I ask for information of your surgeon?

eLaReF
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Date Joined Aug 2012
Total Posts : 74
   Posted 8/15/2013 4:58 AM (GMT -6)   
Hi
 
It will be 10 years in October since I had my Nissen. 
 
I had a full wrap and haven't had any problems since.
 
There wasn't a website like this around 10 years ago and the advice I got was very limited.  I pretty much worked things out myself about chewing and other things, and did some stupid stuff too - like forcing myself to vomit the first time food got stuck in my wrap!
 
So if there is any truth that treating your wrap well in the first few months leads to long term success I am sure any new members of the wrapped club will be still going strong for many years to come.

JohnnnyRebel
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Date Joined Aug 2013
Total Posts : 13
   Posted 8/20/2013 5:14 AM (GMT -6)   
Hopegood: Yes, my surgeon is in the USA. My Surgeon: Dr. Philip L. Leggett who works out of the Houston Northwest Medical Center in Houston, Texas 77090. His web-site is www.drleggett.com.

I was so impressed with the LNF surgery; I had Dr. Leggett perform a bi-lateral hernia repair eight years ago with perfect results. I would not hesitate to trust my life or the lives of my friends and family with Dr. Leggett. I hate to sound like a commercial, but this is the truth.

By the way, concerning my laparoscopic "Classic Nissen Fundoplication" surgery with 6 centimeters of wrap length; immediately post-surgery, I did in fact suffer through four months of fairly severe dysphagia. But, the inconvenience of getting some of my meals temporarily "hung-up" in my esophagus, early on in the process, was more than compensated for by the extra durability of the wrap. The dysphagia resolved completely after five months leaving me with a fundus wrap that could survive severe bouts of retching, coughing, vomiting, or any strenuous physical activity.

It doesn't take a rocket scientist to deduce that the longer the wrap length, the stronger and more durable the new valve muscle becomes.

Compared to the "Classic Nissen Fundoplication," it seems to me the "Modified Nissen Floppy" wrap has two issues - less overall durability and less muscular power to close and prevent reflux- due to the typical short wrap length of 2.5 centimeters or less.

Post Edited (JohnnnyRebel) : 8/20/2013 6:49:44 AM (GMT-6)


opnwhl4
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Date Joined Dec 2008
Total Posts : 4961
   Posted 8/20/2013 1:16 PM (GMT -6)   
JohnnnyRebel

When you are talking about the modified floppy wrap, do you mean the 270 or 180 degree wrap? I ask because I have had a 360 degree floppy wrap and the only difference between it and the classic bougie fitted wrap is that it has less tension while at rest. I have way more than 2.5cm of fundus for my wrap.
I originally had the classic wrap, but it had so much tension because it wasn't freed from the spleen enough to not pull my esophagus that I had dysphasia for almost 3 years until I had it redone by a different surgeon.
I do agree that the less degree wraps are probably more prone to loosening up sooner. also that one has to be a good candidate and have a very good surgeon.

Take care,
Bill
opnwhl4
Moderator: GERD/Heartburn, Kidney disease

Nissen 6/06 and 5/09
#3 8/24/11

JohnnnyRebel
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Date Joined Aug 2013
Total Posts : 13
   Posted 1/17/2014 3:39 AM (GMT -6)   
Bill,

You are confusing terms here. A Nissen Fundoplication is, by definition, a full 360 degree wrap of the fundus, full-circle around the esophagus. Lesser wraps have different names.

A Floppy Nissen Fundoplication (which is modified from the original Classic Nissen Fundo Design) is therefore, by definition, first and foremost a full 360 degree wrap - in all cases. The "modification" referred to when we discuss a "Floppy Nissen" design involves two places where the modification is usually made:

1) Short Gastric vessels attaching the spleen to the posterior of the stomach are taken-down, or “separated,” to "free up" any tension on the wrap.

2.) The length of the "union" where the stomach fundus is sutured to itself is "modified" from an original length of 5 or 6 centimeters, down to a measly 2-3 centimeters: This "union" is the "weakest link in the chain” and restricts the amount of sphincter muscle that forms the new "valve." A 2.5 centimeter "union" (e.g.sphincter muscle valve) is nowhere near as durable or strong as a 5 centimeter "union" because less fundus tissue is available to form the new "sphincter muscle."

Bill, if your wrap is 2.5 centimeters at the "union," there is no more than that amount of muscle available to form the new valve. The rest of the fundus cannot act as a "sphincter" because it is out of position, anatomically.

The biggest "down side" to having the "Floppy Nissen" wrap versus the "Classic Nissen" wrap, is:

A.) The floppy wrap is not as durable or strong and has been known to "tear apart" from dry-heaving, retching, vomiting, or the lifting of weights/heavy objects.

B.) Recent Studies indicate there is NO ADVANTAGE in having the short gastric vessels from the stomach to the spleen surgically separated, 5 years post-op. It is now widely accepted within the medical community that "gas-bloat syndrome," after surgery (a common long-term malady of the Floppy Nissen Surgery) can actually be prevented by keeping the gastric vessels “intact.” Additionally, the dysphasia often appearing post-op with the “Classic Nissen” surgery typically abates completely within a few months.

Due to letters A & B above, there is no “up-side” to having the Floppy Nissen Surgery in lieu of the Classic Nissen Fundo Surgery; other than a short-term (6 months or less) period of time where dysphasia has been minimized. After six months, the Classic Nissen Procedure, with a stronger and more durable “union” (sphincter muscle), is far superior to the Floppy Nissen Procedure – especially when the short gastric vessels between the spleen and the stomach have been left “intact.”

In my opinion, the supposed advantages of a “tension-free” fundo wrap are bogus!!!!

Sadly, many surgeons only care about the immediate short-term complaints and potential law-suits of patients getting food “hung-up” in their esophagus, post-op. It would be in the best interest of these same patients, if surgeons properly educated their patients by telling the whole truth concerning the Floppy Nissen Procedure; including the options available (e.g. Classic Nissen Surgery) and the long-term durability issues of the Floppy Nissen Valve. Any surgeon who claims the Floppy Nissen Fundo Valve is as strong or durable as the Classic Nissen Fundo Valve is lying through his teeth.

Usually, the surgeons who are promoting the Floppy Nissen Fundoplicatiion Surgery claim that a fundo wrap of more than 2.5 centimeters at the “union” is over-kill and is not necessary to stop acid reflux. This argument does not address the real issue. What good is a fundo wrap if it tears apart when stressed?

Anyone who wants their fundo wrap (valve) to be durable and last a life-time under the most strenuous of potential conditions should avoid Floppy Nissen Fundo Surgery like the plague.

Bill, if you have had good luck with your Floppy Nissen Fundo surgery, I wish you continued success.

By the way, Bill, if you had the Classic Nissen Surgery performed originally; and after 3 years you still had food getting "hung-up" in your esophagus, your surgeon was incompetent. I am not qualified to say where your surgeon may have made his mistakes, but he goofed.

Personally, I could never recommend the "Floppy Nissen Surgery" to any friends or relatives of mine.

Long-term, the evidence suggests that Classic Nissen Fundoplication Surgery is the most durable and long lasting solution to GERD; when caused by a weak Lower Esophageal Sphincter.

Post Edited (JohnnnyRebel) : 1/18/2014 7:02:17 AM (GMT-7)


opnwhl4
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Date Joined Dec 2008
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   Posted 1/30/2014 10:17 PM (GMT -6)   
JohnnnyRebel

While I do have a tension free wrap I do not only have 2 to 2.5 cm of wrap. Mine is closer to 2.5 inches. I also have never had the severe gas bloating and such with the tension free wrap.

The issue I see with your statements is that a full wrap can be to tight or to loose whether it is a "classic" or "floppy" wrap. That is strictly in the hands of the surgeon and their expertise.

I have talked with people who have dealt with both ends of this spectrum. Your opinion that the floppy wrap is basically incapable of being a realistic repair is in fact your opinion, but you write it as if it is fact. There are way too many variables for you to make that statement as fact. This is why some people are getting a bit tense about your other posts. The doctors can't even agree what is best. Don't rely on one study, they can be skewed easily.


Take care,
Bill
opnwhl4
Moderator: GERD/Heartburn, Kidney disease

Nissen 6/06 and 5/09
#3 8/24/11

JohnnnyRebel
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Date Joined Aug 2013
Total Posts : 13
   Posted 6/4/2014 11:02 PM (GMT -6)   
Bill,

The Modified "Short Floppy Nissen Fundoplication" was specifically developed to overcome two issues occasionally observed in the surgical patient outcomes of the Classic Long Wrap Nissen Fundoplication procedure (5 to 6 cm long at the union). These undesirable patient outcomes, first observed immediately after surgery and remaining permanently unresolved thereafter, were:

1.) the patient's inability to belch or expel stomach gas orally......

2.) moderate to severe dysphagia.......

The group of bariatric surgeons who worship at the altar of the "Church Of Short Floppy Nissen" felt that by making the length of the fundoplication "union" no more than 2.5 centimeters long and constructing a loose collar of stomach fundus muscle surrounding the esophagus, these two above stated problems would be resolved.

In my previous comments, I said that the real cause of these two undesirable "after effects" IS NOT DUE TO the length or the tightness of the Classic Nissen Fundoplication wrap; but rather the "sub-par" training, poor skill-set, and overall incompetence of the bariatric surgeon. In support of this argument, I point out that these recently discovered issues of permanent dysphagia and the chronic inability to belch trapped stomach gas were virtually non-existent during the era when renowned surgeon Doctor Rudolph Nissen performed his original procedure on his own patients.

You stated that your Nissen Floppy "union" is most likely 2.5 inches in length. This would be 6.35 centimeters - close to being a Guinness World Record length for a Nissen Fundoplication Procedure!!! The only "Long Floppy Nissen Wraps" I am familiar with, have all been performed overseas - not in the USA. Here, most all Floppy Wraps are, by definition, 2.5 centimeters or less in length and are considered "short."

Please, do some research on your own and see if you can prove me wrong! Contact your surgeon and ask him to confirm the procedure he used on your behalf and the length of the "union." It is my educated guess that either you are mistaken about the length of your wrap (confusing inches with centimeters); or, you did not get a "Modified Floppy Nissen Fundoplication" procedure because as I stated earlier, most all Floppy wraps performed in the USA are "Short Floppy Wraps" 2.5 centimeters or less in length. This is a fact, not my opinion.

In the past, I DID NOT SAY that every Short Floppy Nissen Procedure under the sun, would, under conditions of stress, necessarily "fail" or tear apart at the stitches. To the contrary, I noted there are multiple variables that influence the final long-term outcome of gastric fundoplication surgery.

Today, after more thought and review, here is a clarification of what I think:

1.) A Short Floppy Nissen Wrap, if constructed with a minimum of three (3) non-absorbable sutures at the union that are positioned correctly penetrating the fundus muscle tissue deeply and same sutures being "tied off" properly by the surgeon, may in fact be durable enough to provide a permanent "fix."

2.) When subjected to "prolonged stress" like repeated retching, coughing, and vomiting; the more stout and mechanically robust Classic Nissen Fundoplication {with a larger sphincter valve muscle mass} is the superior choice for long term survivability of the procedure. I believe that SIZE MATTERS and the bigger the muscle mass at the union, the stronger the new mechanical valve created by the surgeon. As a matter of fact, I believe the vast majority of bariatric surgeons would not dispute this argument, but would non-the-less resist providing their patients with this surgical option for political and personal reasons.

A "Tension-Free Gastric Fundo Wrap" is an interesting concept that has no universally accepted definition amongst the bariatric surgical community. Some surgeons claim that a "tension free" 360 degree wrap has only one requirement - the surgical separation and dismantling of the short gastric blood vessels between the spleen and the stomach fundus. Under this definition, a Classic Long Wrap Nissen Fundoplication where the short gastric blood vessels between the spleen and the stomach fundus are separated could technically be referred to as being "tension-free." Other surgeons consider that only a "Floppy Nissen Fundoplication" with a loosely formed stomach muscle collar surrounding the esophagus and the surgical separation of the short gastric vessels can be considered "tension-free." Finally, there are surgeons that consider a "Floppy Nissen Fundoplication" without any dismemberment of the short gastric blood vessels to be a "tension-free" wrap.

As I stated in previous comments, I believe the utilitarian advantage of a Short Floppy "tension-free" gastric fundoplication procedure is limited to the first 6 months, post-op. When Classic Nissen Surgery is performed by a competent surgeon, any undesirable "after effects" have typically resolved spontaneously within 6 months. Therefore, there exists zero "added utility" for the Short Floppy tension-free procedure beyond this 6 month time frame. In support of this, I cite my own personal Non-Tension-Free Classic Nissen Surgery where there existed no remarkable toward effects after 6 months.

You are correct when you say that the surgical community is "divided" about this issue of exactly how to "standardize" the Nissen procedure. When it comes to applications where a full 360 degree wrap is indicated, frankly, there is no such thing as a single surgical approach accepted and practiced by an overwhelming majority of doctors and surgeons. Thee exists a great deal of controversy regarding specific methodologies.

I have NOT based my arguments and opinions on any one study or report. My opinions are based on my research from a multitude of different sources including several hours of video footage of actual Nissen Fundoplication Surgeries; from my own personal experience with Classic Nissen Surgery as a patient; from my background in mechanical engineering and physics; and from common sense and sound logic. I view the subject matter of this particular discussion {e.g. the gastric fundoplication durability issue} as an exercise in problem solving. And, my conclusion is that for those patients who are good candidates for a full 360 degree wrap, Doctor Rudolph Nissen solved the durability issue with his original fundoplication procedure.

In the future, I hope for a strong resurgence of popularity amongst the masses for Doctor Nissen's Classic Fundoplication Procedure; similar to the resurgent popularity of the "Coca-Cola Classic" soft drink!

Concerning the "comfort level" of other people participating with this thread, when I have made mistakes or errors, I have been cordial and positive and corrected my misstatements by formally admitting these errors publically. I have no "axe to grind." But, I will admit, I can become very passionate about causes where I believe I have the strongest arguments comprised of both verifiable facts and personal opinions. I hope my opinions serve as "food for thought" that motivates others to do some research on their own, "thinking outside the box." Imagine "what if" becomes "eureka."

I consider myself to be a good person and as such I bear no malice or ill-will toward anyone. I wish only the best of luck and success for all of those individuals who come here to seek advice and the brotherhood of common cause. If I have offended anyone by being insensitive or rude, I sincerely apologize for my unintentional slight.

By the way, I view my own "healthy skepticism," regarding bariatric surgeons, beneficial to those who have not yet made a decision concerning their GERD options. And, isn't the American Citizenry being "better informed" {in this case, through my skepticism and challenges to the current mainstream paradigm} the primary function of this thread after all???

Sincerely,

JohnnnyRebel

Post Edited (JohnnnyRebel) : 6/5/2014 10:34:28 PM (GMT-6)


opnwhl4
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Date Joined Dec 2008
Total Posts : 4961
   Posted 6/6/2014 2:18 AM (GMT -6)   
JohnnyRebel-

The way my 3 wrap were done were closer to the original Nissen. Unfortunately my 1st was done by an under experienced general surgeon (bariatric) and it had a lot of tension on the wrap because of a lack of dissection of the gastric vessels and not using the correct area of the stomach. I have always said my 1st surgeon did it incorrectly and I didn't do my research correctly before going ahead with my 1st surgery.

This was redone by a thoracic surgeon who still uses approx. 5 cm of fundus, but also makes sure there is no tension on the wrap by dissecting the vessels enough that the wrap isn't pulled. With my last redo I again had a thoracic surgeon who is very close friends with my 2nd surgeon. Due to my esophageal perforation they talked and decided it would be best to redo things pretty much as before with the exception of a slightly longer wrap. you are correct, my estimate of 2.5 inches was a bit off. It's closer to 2 1/8th (Sorry I'm backwards, stuck in my ways and dislike the metric system), doc said 5.5 cm when I saw him in April. Again great care was taken to be sure the was nothing pulling on the wrap.

Doc #2 explained his views to me about the tension as tension being pressure applied to the whole wrap and that pulling on the esophagus vs. tightness of the wrap being the squeezing pressure applied around the esophagus.

The only reason for my 2nd redo was due to what had to be done to save my esophagus after the perforation. If it wasn't for this I would still be on the 1st redo.

I agree the purpose of this thread and forum is to help others be better informed. This is why myself and many others recommend getting all the proper testing and finding out their surgeon's track record before going ahead with any of the surgeries. I didn't do this the 1st time and was lucky enough to find someone who was able to correct things.

Take care,
Bill
opnwhl4
Moderator: GERD/Heartburn, Kidney disease

Nissen 6/06 and 5/09
#3 8/24/11

JohnnnyRebel
New Member


Date Joined Aug 2013
Total Posts : 13
   Posted 6/7/2014 12:49 AM (GMT -6)   
Bill,

I am happy about your recent good luck regarding your third Nissen Fundoplication Procedure. It sounds like you have an accurate appraisal of what happened "wrong," previously. I hope this most recent surgery lasts a life-time for you!

Technically speaking, your third Nissen procedure was in fact a "Long Floppy Wrap." Wonderful!!! Kudos! As you know, from an engineering standpoint I am biased toward having a longer wrap with more sutures and more sphincter-muscle mass created {based on my research, I also have a very strong bias toward the surgeon using BRAIDED POLYESTER SUTURES THAT RETAIN FULL TENSILE STRENGTH INDEFINATELY and NOT SILK OR NYLON SUTURES}.

Through your example, I can see that a "Long Floppy Nissen Wrap " has value by being tension-free and loose. I will admit, I may have been too harsh in my negative opinions about the concept of "Floppy" surgery in general. My own wrap was constructed with so much tension, that, during the first 12 months; an empty stomach would trigger an excruciatingly painful, 90 second long, upper esophageal muscle spasm. But I digress......It seems the Long Floppy Nissen was ultimately the perfect solution for you!

I agree with you about the importance of finding a good and competent surgeon. The appropriately selected and well informed candidate and the highly experienced and gifted surgeon are the keys to a long-term success. Simply relying on "random good luck" or hiding one's head in the sand, concerning key issues that should be investigated prior to any surgery, makes for nothing but a crap-shoot!!!!


Respectfully yours,

Johnny R.

Post Edited (JohnnnyRebel) : 6/7/2014 5:35:20 PM (GMT-6)


Alcie
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Date Joined Oct 2009
Total Posts : 5004
   Posted 6/7/2014 2:12 PM (GMT -6)   
Hi guys.

There is good reason not to do the full Nissen - if it's not right for the patient. I was given a Toupet, a partial wrap, because I'd never have been able to swallow past a full wrap (post polio). I had a renowned group of thoracic surgeons, which IMO is the way to go, who had me do 3 months of testing.

One of the concerns was a slightly short esophagus. A worse one was my GPEH. They had to "take down" the esophagus to get it below the diaphragm, but at least didn't have to do a Collis.

At 5 years and a few bad episodes of heaving (can't actually vomit), my stomach showed on CT partly above the diaphragm, possibly something else going on, although wrap looks intact. I've got a sore throat, no infection. I'm due to see the group for followup in Nov or Dec. I didn't go last year because they wouldn't promise not to have me seen by the resident who said he was going to do a dilation even though I refused it. I don't have a gastroenterologist right now, can't find one I trust.

These procedures shouldn't be done by just one surgeon. While I had a top one overseeing everything, he had a whole team working. Of course in a university setting where there are residents training, only the best ones get to do anything more than a few seconds.

SEW LADY
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Date Joined Mar 2014
Total Posts : 17
   Posted 6/7/2014 4:55 PM (GMT -6)   
Hopegood - I had a very experienced surgeon in FL do my wrap. If you are close I can give you his name.

FlaCracker
Regular Member


Date Joined Oct 2013
Total Posts : 234
   Posted 6/8/2014 2:54 AM (GMT -6)   
Where in Florida and what is his name? Does he use assistants or other surgeons in the procedure?

Michelle
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