Reversal of a fundoplication

Go to Mayo before you do anything else.. get an appointment as soon as possible.. My Nissen could not be reversed was the determination at Mayo.. 1 in 6 Nissen operations have complications

I would suggest to have an esophagram and barium swallow done to check the severity of reflux and to also have an esophageal motility study done to see if you swallow is normal. If it is have the LINX band placed.
I just went through all this last Dec. and had surgery in Jan 2019. I had a rerepair of a large hiatal hernia, the slipped wrap from a a 24 yr old Nissan was removed,so my stomach is normal now and LINX band placed. I'm reflux free for the first time in 30yrs.
If you get the LINX band you must eat every 2-3 hrs for at least 3 months to stretch the band while scar tissue forms around it so as to prevent the scar tissue from creating a stricture enveloping the band and making swallowing more difficult.
Once the reflux stops you can wean off the PPIs. I've weaned very slowly off my prevacid because I was double dosed for many many years. I've read that you can develop really bad rebound acid production if you don't. This week is my last week of prevacid where I am only taking 2 for the whole week. Yeah!
This month I am having my 1st Endo since surgery to see if the last 2cm of Barrett's just above the LES healed up. If not this will be RFA #6. Hopefully it will be the last. I use to have 8cm of Barrett's and medicated for over 24yrs with PPIs. This alone will depleat your B12 stores and cause Calcium loss in your bones.
Make sure you know what your bone density is and your B12 levels because your binding capacity will be low.
Good luck with everything 🙂

Thank you @ken82 and @sylvias - so 17% of Nissen fundiplications result in complications if I’m doing my math right. That means 83% go well — and that makes me feel better!
Mine won’t be a Nissen reversal actually. Sounds more like it will just be a second Nissen since my first one no longer exists! I’ll Confirm that after I talk to my gastro doc and Nissen surgeon.
I don’t think I’m a candidate for linx. When I had my first Nissen they said at least a third of my stomach was in my esophagus and the opening between the 2 was huge. But I will ask about it.
I am fortunate to have docs who keep very close tabs on all of my “levels” — B12, calcium, magnesium, etc.! So far so good even after over 20 years of Prevacid!
Congratulations on your last week of prevacid — that is soooooo amazing!

I had a revision of my 360 last year... toupet this time. Still having bad reflux, choking/coughing at night (sleep study negative for apnea). Surgeon wants to do a partial gastrectomy w/ a Roux-en-y. He said the last surgeon should not have done a Nissen revision and should have done a bypass instead because I had dysmotility of my esophagus so wrapping it again would exacerbate the reflux, which it did. Insurance will pay for the bypass, but they won’t pay for the takedown bc there’s no CPT other than unlisted which they consider “experimental.” Can’t do a bypass until the wrap comes down. Even though my deductible is met I am still having to “cough up” $5,000 up front to pay for the takedown. Is there any way to get insurance to see that this is medically necessary and that the wrap is making my symptoms worse? How come the takedown was paid for in the revision?

why did you have to have your 360 revised? what were all your symptoms/ i had a 360 done 2.5 years ago and it has been bad for m e since. i have had no reflux, as proven by all the testing. i have weakened esophagus muscles due to probably my Rheumatoid arthritis. after the last barium swallow i could see that water hangs up above the wrap since it is so tight. the surgeon wants me to have an egg swallow test (with a radioactive tracer) to see how long the food stays in my stomach . if it is too long, which can cause esophagus irritation then surgeon will inject botox into the outlet of the stomach (pyloric sphincter) to allow the emptying to be quicker. be very careful of the bypass. i know of a friend who has had this and she has many more problems. when you did your last esophagael manometry what was your "distal contraction integral" value? it should be between 500-5000. if yours was less than 500 (mine is 398.3) then you may have an "hypersensitive esophagus" as i have. prior to fundoplication it was 517.3 ( just above the minimum)....if there were any promotility drugs availiable then your symptoms mayhave been not so severe. your sutgeon needs to recode this as mandatory surgery.... good luck and god bless....kozlo52

My 360 slipped and I had a paraesophageal hiatal hernia. My esophagus was completely compressed...I couldn’t even swallow water. The surgeon that did it even noted several times that there was diminished motility. The wrap should have come down and stayed down instead of wrapping it again. The wrap further increased the pressure gradient in my esophagus. My vagus nerve was also damaged which caused gastroparesis evidenced by a gastric emptying study. Gastric bypass is an approved surgical treatment for GERD (as well as paresis) in patients whose Nissens have failed. It just makes no sense to me that insurance agrees that the bypass is medically necessary in this case, but won’t pay to reverse the wrap that’s exacerbating my symptoms. Can’t do the medically necessary bypass until wrap is taken down.

My Nissen was done in Iowa, they couldn't figure out what went wrong but MayoGI figured it out in a morning of tests. They said my Nissen could not be taken down or reversed.. it would be worse than before.. I t was explained to me that some of the hair net like nerves that cause the stomach to empty were damaged and I would depend on gravity and time... learning to cope has been a long process. Every meal or time I eat is a challenge..

what are your symptoms when eating? heartburn, mouth burn. throat burn? i 'd be interested in hearing your experience...thanks... kozlo52

I cannot eat very much at a time. Sometimes food seems to be caught for a little while. It takes an hour or more in any meal . Grazing works best that is, for example: in the morning take my pills, have coffee...in 20 minutes have a banana, while eating on that over 15 minutes...make some raisan toast with real butter, more coffee, while making oatmeal.. do 1 slice of bacon..cut in half prior to microwave...this process while doing a crossword often lasted 90 minutes...I am retired. When food is caught and that foam starts, it is best to let it come up...then start again in 20 minutes...when I eat that slow I rarely have trouble.. orange juice take only a little at a time...I try to have some citrus every day to combat kidney stones... Trail mix is great...cheese and crackers work for me...no carbonated beverages..unless it is flat over a lot of ice and vodka...or whatever..

I don't have any of those burning sensations