Nissen Fundoplication 360 wrap and desired outcomes

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Gastricman
Regular Member


Date Joined Jan 2013
Total Posts : 294
   Posted 1/21/2013 9:24 AM (GMT -6)   
Hi folks,
 
I am seriously debating (and losing sleep) having to make a decision between the LINX System and a 360 total "loose" wrap with the Nissen done laparoscopically. I need to have something done fairly soon since my PPI is not giving me the control which I so desperately need.
 
From what I have been reading on this forum (so far) the LINX appears to have the edge, due to the minimal amount of side effects. However, I know that the NF is the "gold standard" but appears to have a large degree of deleterious side effects which gives me great pause. i know that this surgery supposedly has been "refined" over the years - to what extent, I don't know.
 
Are there people out there who have little/no side effects from the NF, or is it just the nature of the surgery and to be expected? Is there a high quality of life after the NF vs. the new LINX procedure or is living just an existence with the NF?
 
I am trying to be optimistic about the NF but it is hard when I read all the posts concerning it. Then again, the LINX is so new that there is no real long term > 4 years real life data on it to reassure me.
 
For me (and probably others) it is an uncomfortable situation to be in, certainly not like removing your appendix.
 
Thoughts/opinions would be highly appreciated, especially from people who have had the same type of NF stated above post 3 years surgery. If anyone has also had it done robotically, that would be a plus, but not required.
 
Thanks in advance.
 
Gastricman :-)

Post Edited (Gastricman) : 1/21/2013 8:28:26 AM (GMT-7)


dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7181
   Posted 1/21/2013 9:39 AM (GMT -6)   
Hi Gastricman,
Welcome to Healing Well!  I had a laproscopic (not robotic) Nissen in February 28th, 2009.  Like you, I fretted over the decision and worried a lot about the possible negative side effects.  When you Google the procedure, the internet is filled with horrible stories of terrible outcomes. 
 
I had the surgery because my reflux was causing my asthma to be uncontrollable.  My lungs were in a dangerous condition.  I didn't know if the surgery would cure me, and was afraid that I'd end up with debilitating side effects for the rest of my life.  Reading the posts that are all over the Web, it's easy to be scared.
 
I had the surgery because I didn't have a choice. I had to try.  If it didn't work, at least I could rule out reflux as the cause.  I was prepared for a horrible recovery and was very pleasantly surprised.  Here's my early recovery journal:
 
Keep in mind that Nissen results and side effects are skewed in online forums.  People with problems are more likely to post and seek help on the internet. 
 
In my experience, after participating in this forum for the past four years, many of the scary posts are written by people who are experiencing normal healing symptoms.  Surgeons don't tend to prepare their patients for the recovery, and often set unrealistic expectations.  (Recently I heard of one surgeon who said he had patients who went golfing after the first week. That isn't going to happen, and shouldn't.)
 
Sometimes the problems these people are experiencing are a by product of poor surgical procedure of an inexperienced Nissen surgeon. It is very important to research your surgeon very carefully and be sure to look for one who is experienced in the Nissen procedure in particular.  It's an art form, and requires practice and experience to get it right.
 
I lead a normal life post-Nissen.  I eat anything I want to eat, and don't even think of my wrap.  That said, I do have a very sensitive and reactive stomach, so there are times when that bothers me.  It's not wrap-related and unique to me.
 
This is, I'm sure, nothing new to you, but here's a link to information regarding GERD treatment options:
 
Good luck making your decision!
Denise
GERD/Heartburn Moderator
Nissen Fundoplication 2/09
Allergy/Asthma

"Whatever you fight, you strengthen, and what you resist, persists.”

“Worry pretends to be necessary but serves no useful purpose”

“Accept - then act. Whatever the present moment contains, accept it as if you had chosen it. Always work with it, not against it.”
Eckhart Tolle

Gastricman
Regular Member


Date Joined Jan 2013
Total Posts : 294
   Posted 1/21/2013 10:09 AM (GMT -6)   
Hi Denise,
 
Thanks for your reply!
 
I agree with everything you has said in your post.
 
My experienced, intended surgeon, wishes to use the DaVinci Robotic system for the toal loose wrap NF, of course, done laparoscopically.
 
He mentioned that "it is a beautiful operation" and that I would stay overnight and be probably home the next day. He also indicated that I could go on my treadmill, ASAP, and do cardio, but not yoga (not that I do it anyway.)
 
When asked about all these other side effects he said that they would last anywhere from 4-8 weeks and that I would be able to vomit (forgot to ask about the time frame on that.) He wanted me back to ask more questions.
 
Sound too good to be true?
Any recommendations for top NF surgeons in the NYC area?
 
Thanks,
 
Gastricman :-)
 
P.S. Doubly agree with you that many people coming to these forums have had a negative experience first, rather than the successful ones glowing over the positive.  turn

Post Edited (Gastricman) : 1/21/2013 9:13:08 AM (GMT-7)


opnwhl4
Forum Moderator


Date Joined Dec 2008
Total Posts : 4961
   Posted 1/21/2013 1:40 PM (GMT -6)   
Gastricman

I have had a nissen since June of 2006. Although it was done incorrectly and had to be redone May of 2009 and again in August of 20011( unavoidable due to repair of esophageal tear) it has gave me back my quality of life pre GERD.
I have no limitations and the only lasting side effects I have is the inability to physically vomit. I still can get nauseous and dry heave and keep anti nauseous meds on hand for that. I can burp fairly well, but not a complete pre nissen belch.
The 1st nissen being done wrong I blame myself for not doing my homework and making sure my surgeon was competent to do this surgery. The last 2 were done by very qualified surgeons and are perfect. I would still be on my first redo if it wasn't for my esophageal tear.

Here is a link to my story of the 3 nissens and the esophageal tear if you are interested
www.healingwell.com/community/default.aspx?f=45&m=2337138

If I ever need another redo I won't hesitate to schedule another one. The only regrets I have about the nissen is that I didn't have it done sooner. I dealt with GERD for about 17 years before I had the nissen and the last 7 years it was completely out of control.

Take care,
Bill devil
opnwhl4
Moderator: GERD/Heartburn
Nissen 6/06 and 5/09
#3 on 8/24/11

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7181
   Posted 1/22/2013 11:19 AM (GMT -6)   
Hi Gastricman,
I have a treadmill and went on it after just a few days.  You will need to listen to your body.  You're going to want to go slow at first, then gradually increase your intensity.  You'll want to walk only until the healing has progressed quite a bit.  All that bouncing will not feel good to your insides. Remember that this is major surgery even though it is done laproscopically.
 
It's hard to pin down the exact time you'll feel back to your old self.  It's a gradual process with ups and downs.  Sometimes just when people think they're free to eat whatever they want, they'll forget to chew carefully and irritate their wrap.  It'll set them back for a week or so.
 
If you can surrender to your recovery and let it lead the way, you'll do just fine.  Listen to your body. Follow its lead.  You can't rush the recovery, no matter how hard you want it.  It will happen when it happens!
 
I agree that the side-effects like bloating, etc. begin to subside at somewhere around 8 weeks.  That doesn't mean that you'll be fully healed, though.  It takes a full 6 months for most of the healing to occur.  Then it will be another 6 months or so for your body to adjust to the changes.  During that time, though, you'll be living your life normally, with just a few quirks that will resolve in time.  You will always have to eat more slowly and chew your food more carefully, though. 
 
This is a great place to get your questions answered.  Stick around!  Hopefully somebody will be able to provide you with some information about surgeons in the NYC area.  You're in the perfect location.  A huge metro area like that will have the best of doctors and medical facilities. 
 
Good luck!
Denise
GERD/Heartburn Moderator
Nissen Fundoplication 2/09
Allergy/Asthma

"Whatever you fight, you strengthen, and what you resist, persists.”

“Worry pretends to be necessary but serves no useful purpose”

“Accept - then act. Whatever the present moment contains, accept it as if you had chosen it. Always work with it, not against it.”
Eckhart Tolle

Gastricman
Regular Member


Date Joined Jan 2013
Total Posts : 294
   Posted 1/22/2013 1:58 PM (GMT -6)   
Hey Denise,
 
I totally understand. This particular surgeon who I have in mind makes it all sound so easy, even though he wants me back to ask him questions. In no way is he rushing me. I really need to cover all the bases and that takes time.
 
Best,
 
Gastricman :-)

Alcie
Veteran Member


Date Joined Oct 2009
Total Posts : 5004
   Posted 1/22/2013 5:43 PM (GMT -6)   
It's most important to listen to the doc when he tells you what YOU NEED, not what you think you want based on reading all our complaints. Don't get yourself all hysterical that you might have complications, especially that the complications we report. Most of us are glad we had the surgery. We needed it, and it has by and large helped us.

I'm with Bill on the vomiting and burping. I dry heave, so keep the anti-nausea meds with me at all times. I burp a little but not like before. It's fine. Not a big, scary deal like you read about.

I had the Toupet variety of Nissen, a partial wrap. My doc chose it during surgery because it was the right thing for me. I have a very weak swallow and wouldn't have been able to swallow past a tighter wrap. I asked him about all the new stuff and he said he and his associates and his team have tried - I don't remember all the ones we discussed - and he doesn't do them any more because they did not produce as good outcomes. I am happy I was referred to the top surgeon in my area (not NYC) and trusted him to give me the procedure I needed.

eLaReF
Regular Member


Date Joined Aug 2012
Total Posts : 74
   Posted 1/23/2013 3:05 AM (GMT -6)   
Hi Gastricman
 
I had my Nissen back in 2003.  I had no complications and haven't had a single PPI since.
 
I can eat whatever I want now - apart from raw red onion which makes me really uncomfortable for some reason (I suspect this could be an allergy I never noticed before the op, given that I had reflux from pretty much everything I ate back then). 
 
There are some constraints you may have read of - in that I can't vomit or burp, but this hasn't really been a problem. I also chew more and eat a bit slower than I did before the op - but to be honest I don't notice this anymore and I only really think about it when I see similar posts on this forum.
 
The statistics for success seem to have improved over the years and they do show a significant majority of people having the op now have a high probability of being symptom free for 10 years plus.  I'm guessing that this is because the op has only been around for 10 years or so to collect this data from, as I'm pretty certain my wrap isn't going to just explode sometime this year :)
 
You are in a good place to collect information on this forum so take your time, gather your facts and make the right choice for you.
 
Hang in there.
 
Les.
 

Gastricman
Regular Member


Date Joined Jan 2013
Total Posts : 294
   Posted 1/23/2013 10:48 AM (GMT -6)   
Hi eLaReF,

Thanks for your information. I really appreciate it.
By the way, I find it a bit funny that your first name is LES (Lower Esophageal Sphincter)  tongue

Regards,

Gastricman :-)

Post Edited (Gastricman) : 1/24/2013 10:40:51 AM (GMT-7)

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