Hello,
Starting this thread to document my path forward after failure of my Nissen Fundoplication in July 2018 and to see if I can get some feedback from those who have experience with revision surgery. (I've been reading all of the old posts on this subject but it seems those folks aren't around much anymore, if at all.)
I had my LNF surgery in October 2013. Everything was going great; the decision to have surgery was one of the best I had ever made. All of my symptoms prior to surgery were completely gone. Unfortunately about mid-July I got very sick to my stomach and suffered from violent dry heaving that I could not get under control with Zofran. All of my symptoms came back within a few weeks. I knew this surgery might not last forever, but I hadn't expected to be headed back down this road so soon.
I've had a barium swallow come back normal, but given the return of my symptoms, my surgeon also ordered an EGD. The EGD has shown that my wrap is loose. Tomorrow I go in for manometry to test my esophageal functioning.
Right now I am back on PPIs, but still having trouble swallowing and am experiencing regurgitation pretty regularly. My EGD showed no indication of esophagitis, so the difficulty swallowing is a bit of a mystery but hopefully the test tomorrow will shed some light on that. It also showed a small diverticulum in the distal esophagus. GI doc said not to worry about that. I have read they can be caused my a motility disorder, but given that I have not had any symptoms of that prior to the dry heaving, I wonder if this could have actually been caused by the changed pressure from my wrap (when it was still functioning).
Follow-up with my surgeon is next Tuesday, to discuss the path forward and determine whether any more tests are needed. I am dreading the 24 hour pH test, which I expect will be required in the coming weeks.
Also looking into a surgeon in Atlanta who has had success with the Linx in failed fundoplication patients.
This is all very scary for me as I have read revision surgery isn't as likely to be successful as primary surgery. However, I hope that my personal success, and the success of my surgeon, with my first surgery is a good indicator that a revision will go well for me.
Had the manometry test today. It was every bit as unpleasant as I remembered, but the nurse was much nicer this go round. Had far less trouble with double swallows. Finished in about 30 min. Unfortunately the nurse told me they can't send the results directly to my surgeon, that it has to go through my GI doc first. Calling his office tomorrow to ask if they can prioritize it since I see the surgeon on Tuesday.
24 hr pH test is scheduled for Sept 10 at 1 PM. No food or water for 6 hours before. Ugh. Have to stop taking PPIs and Zantac as of this Monday. Not sure how much they are helping anyway, but not looking forward to the prospect of acid rebound.
The amount of time that all this testing takes is very frustrating.
24 hr pH test is scheduled for Sept 10 at 1 PM. No food or water for 6 hours before. Ugh. Have to stop taking PPIs and Zantac as of this Monday. Not sure how much they are helping anyway, but not looking forward to the prospect of acid rebound.
The amount of time that all this testing takes is very frustrating.
Went to see my surgeon yesterday. In his opinion the EGD looks fine and is not conclusive enough to prove the reflux has returned. So the path forward hinges completely on the results of the 24 hour pH test. Last time I had this test, I had 64 episodes of reflux, which I understand is in the normal range. However, 40 reached my throat, which is not normal; hence why I had the surgery. Am concerned that the pH test will not show anything definitive and I will be stuck.
Have an appointment next week with another surgeon in my area who does revisions, so at least I have a back-up plan.
Have an appointment next week with another surgeon in my area who does revisions, so at least I have a back-up plan.