Hi Chris, if your "small hiatal hernia" is less than 2cm it is my understanding that during the TIF they would first use mild suction to move the hernia down to its proper position with the rest of the stomach. Then it's the surgeons choice to suture over the top of the stomach at the diaphram juncture and/or then use mesh to lessen that diaphram opening where the esophagus goes through (my surgeon's PA said that juncture is "V" shaped, and with a hernia it can become a much larger "V" shaped opening in the diaphram and that's why he uses mesh).
There are several YouTube videos on TIF and even an animation from the ESOPHY X medical device.
In answer to your questions:
1. I don't think anyone knows how long a TIF will last, although my surgeon said he feels it could be a forever fix. My doc previously only did Nissens and now he really concentrates on TIFs and has basically stopped all Nissens except in some unique cases. (I don't know what that may be, I didn't ask) So maybe my surgeon might be a bit prejudiced?
The surgery itself lasted 3 hrs. but a good 20 minutes of that is repositioning the patient from their back (for HH repair) to their left side for the TIF (lots of wires and hoses!)
The doctor who did mine was VERY VERY casual about recovery. No restrictions on coughing, burping, swallowing meds or supplements. He said "what are you going to do if you gotta burp? go ahead"...etc. He did caution against any waves of nausea but reassured me that so far that has been very minimal in his TIF patients. In one of my followup appoinments I said "are you that secure that your sutures and mesh will hold" and he said YES! I did request some Zofran (anti nausea) just in case.
2. Yes, if there is some kind of partial or full failure (I specifically asked my surgeon...although as he thought about it he couldn't think of any scenario where that would happen) the TIF can be repeated. As you read on the forums, I have come across some posts where people have had a Nissen redone 3 times! I believe a Nissen is a full 360 wrap. A TIF starts at 270 and it is the surgeons discretion if he/she wants the wrap to be fuller. My doc said my wrap is almost 300 degrees.
Your road of Naturopathic, DGL, Aloe, (I even drank slippery elm) YUCK ! sounds so familiar. I also tried acupuncture, deep breathing, relaxation exercises thinking if I could control stress, I could control acid. When the problem is mechanical, your impact with those alternatives is minimal, but I had to try.
It is fascinating how the stomach tissue can "meld", or whatever word is correct, to the sides of the esophagus and reinforce a very floppy LES...I also asked specifically how that happens and got a very technical answer!
Good luck with whatever procedure you have...but it definitely changes your life in a good way to be normal again, and have a beer, wine, scotch etc. And carbonation is NOT a problem as long as you can burp!
Any other questions I would be glad to answer if I have an answer. Kathleen