Testing before Nissen

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Regular Member

Date Joined Jul 2012
Total Posts : 35
   Posted 1/26/2013 7:57 AM (GMT -6)   
I am scheduled for surgery for a giant paraesophageal hernia this coming Wednesday at UPMC. This surgery usually includes a Nissen fundoplication. Yet I have not had a manometry test or 24 hour pH Probe. Does that sound right to you all?

Veteran Member

Date Joined Jan 2011
Total Posts : 513
   Posted 1/26/2013 10:09 AM (GMT -6)   
Hi.i would ask for manometry to be carried out,ive had a nissen fundoplication done and am having all sorts of problems with swallowing and reflux ,my surgeon never carried out a manometry test,he,s going to do one now,a bit late i think! Please get all tests done carefully so you dont end up in trouble.Barry

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Date Joined Feb 2009
Total Posts : 7188
   Posted 1/26/2013 10:12 AM (GMT -6)   
Hi cuicui,
With a hernia like yours, they don't need to know how much you're refluxing to determine whether or not surgery is required.  It's a critical situation and there is no doubt.  Therefore, the PH monitoring is a moot point.
The manometry is another issue.  Since they're likely doing a Nissen, it seems like they'd want to know your swallowing abilities.  However, they may be planning a partial or loose wrap anyway, in which case that wouldn't matter either.  The manometry determines whether or not your swallowing reflex is organized and strong enough to get food through a full wrap, which is tighter.
My guess is that's the reason, but you could ask.  It makes sense to me!
Good luck with your surgery!  We'll be waiting to welcome you to the Wrapped Club if you get one! 
Best wishes,
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Nissen Fundoplication 2/09

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Regular Member

Date Joined Nov 2012
Total Posts : 105
   Posted 1/26/2013 1:42 PM (GMT -6)   
Yeah denise is right surgery is the only option with the hernia you have all the best and good luck with the surgery

Elite Member

Date Joined Apr 2007
Total Posts : 32602
   Posted 1/26/2013 4:37 PM (GMT -6)   
The patient's preoperative evaluation of a patient  with a giant paraesophageal hernia (includes a barium esophagram and upper endoscopy. A 24-hour esophageal pH study and/or esophageal manometry is obtained in some cases. It may be difficult or dangerous to instrument the esophagus so pH or manometry studies are frequently omitted. Endoscopy is usually performed at the time of surgery. If it is difficult to enter the stomach the scope is left in the esophagus until after the stomach has been reduced back into the abdomen. It is then easy to perform intraoperative endoscopy to evaluate the esophagus and stomach for pathology before proceeding with the repair.
Remember each person is different and I feel it would be wise to call your surgeon re your concerns.  Do be your own best advocte and we will be your cheering squad.
Wishing your the best with your surgery.
Moderator: Anxiety, Osteoarthritis,
GERD/Heartburn and Heart/Cardiovascular Disease.

“Have courage for the great sorrows of life and patience for the small ones; and when you have laboriously accomplished your daily task, go to sleep in peace. God is awake.”

Veteran Member

Date Joined Oct 2009
Total Posts : 5029
   Posted 1/26/2013 4:55 PM (GMT -6)   
Same doc for my GPEH 3 years ago - I had all the tests. My pH was a failed study but he said it wasn't really necessary. Maybe I had the manometry because I told them I had a weak swallow. I had the barium swallow before going to the surgeon to find out what was causing the horrible pain. That showed the difficulty swallowing.
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