I will weigh in on the "how many Nissens has the surgeon done" topic...better late than never?
Having participated on this forum for several week before my surgery, I knew the importance of choosing the right surgeon for the procedure. I discussed this with my PCP. I even considered traveling to a center like Cleveland Clinic. My PCP was concerned that if I did, I'd have to travel back, should there be any problems.
He had referred me to a surgeon of his choice, because my GI doc was dragging his feet, and he was so frustrated. (I had uncontrollable asthma that he was certain was being made worse by reflux, but my GI doc wasn't convinced.)
I wasn't sold on the surgeon, and really wanted to discuss the situation (and further testing, as well as that surgeon's decisions that I was a good candidate for surgery) with my GI doc, who had been dragging his feet for four years.
My GI doc listened to me, and did yet another 24 hour pH test. With the continued pressure from my PCP, the testing and recommendation of the other surgeon, and the new pH test that was a little higher (borderline normal, but still a bit higher), he finally decided that indeed, "a few good reflux episodes a day could cause problems with my lungs."
He referred me to a surgeon (as a possibility...no rush! I could continue treating my reflux with medication! As if that was working...). It was a general surgeon, whose office was actually across the hall in the same building as my GI doctor's large group office. I questioned my GI doc, who said that he would use that same doctor if he or any of his family needed a Nissen surgery.
I met with the surgeon, and he expressed some concern as to the fact that my pH testing was so low. (Surgeons prefer very high pH/DeMeester scores. Mine was just under 15, with the normal range ending at 14.) Yet, he took into consideration my PCP's and allergy doctor's opinions, and said he would do the surgery. He told me that if my asthma was being caused by reflux, then the surgery would help it.
At that time, I lived in a fairly small city (population 250,000), and when I asked my surgeon how many Nissens he had done, and he told me that he had been doing the procedure laproscopically for 10 years, and estimated that he had done well over 300. (He actually did 2 the day he did mine.)
I also asked him his track record. How many redos he did. He said he'd only taken down one...a man who was a big burper pre-op and couldn't deal with the lack of ability to belch after surgery. Also, he'd done a re-do procedure after someone had a car accident that herniated their wrap.
I was fortunate to have a friend who was a nurse anesthetist in the hospital where my surgeon practiced, and he told me that my surgeon was the one he would have should he or his wife need the procedure.
Three weeks later, I had my surgery. The rest is history!
(My Nissen recovery journal is here, for anyone interested:www.healingwell.com/community/default.aspx?f=45&m=2183443
I now live in a city of 375,000 with a large medical university and hospital. I have discovered that, while there are several surgeons who do the procedure, there is only one who is recommend by the best doctors as, quote, "the one who does all the Nissens".
So in answer to your question, if I were to look for a surgeon to do a redo (which, by the way, is much more challenging and requires an even higher level of expertise) or even an initial Nissen in any city, I would call around to GI offices and top ENT/head-neck surgeons and ask who they refer to for Nissen surgeries. If one name comes up repeatedly, that's the one I'd choose.
On a side note, I've read that since the procedure went laproscopic, it has helped reduce the number of surgeons doing Nissens, and in so doing, has allowed those surgeons a great deal more experience, thus increasing the procedure's success rates.
Thanks again, Pat, for the great thread! It was a wonderful idea to start it. Thanks also, for moderating it, and keeping it going!Best wishes,