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Reversal of Nissen Fundoplication
Digestive Health | Last Active: Jul 16 2:18pm | Replies (108)Comment receiving replies
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?
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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