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Reversal of a fundoplication

Digestive Health | Last Active: Sep 1 10:51pm | Replies (256)

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I had a Nissen Fundoplication procedure done last Oct. I have not have success with it at all. The wrap was to tight and I have to have a dilation done almost every two months. I am looking at have a reversal done and wonder if anyone has had this done and if so, did things improve Thank You

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Replies to "I had a Nissen Fundoplication procedure done last Oct. I have not have success with it..."

My 22 year old son had a NF wrap that was too tight. He had the dilation with only 24 hour's of relief. If the wrap is too tight dilation will not help! Think a tight rubber band.
Dr. Steven Bowers at the Mayo in Jacksonville. Tore down the NF wrap and did the Linxs device. However, unbeknown to Dr. Bowers or us. My son's body makes very fibrous scar tissue. Now 2 year's later only two of the 12 bead's are working. He lost so much weight he has SMA.syndrone, had the by pass surgery to go around the dueduom. Which helped take his pain level down from a 10 to a 5... Most of the time after eating. His food gets stuck for 20 minutes or longer before finally dropping into his stomach. He's had a feeding tube for 2 year's now. Will probably live the rest of his life with a G tube. As he will never be cured from the SMA. He's unable to work currently and desperately trying to get SSDI
Back story, he was born with a problem with his esophagus spinchter and was 11 months old when he had his first Nissan fundoliplication.
That 2nd wrap in 2014 destroyed his life. He's been in severe pain ever since.
Meeting Dr Bowers at the Mayo saved good life. However, we now accept he will never have a normal life.
I personally would never suggest to anyone a NF!
However, they can reverse the NF! seriously anyone that can get to Jacksonville FL to the Mayo and see Dr. Bowers! He's the best surgeon ever!

Hi All

I had my complete Nissen in Nov of 2012. Initially I thought I had ruined my life, I wasn't able to swallow anything other than liquid and jello for weeks. I lost 35 pounds in 8 weeks. However, over time, I was able to gradually return to normal eating. Every once in a while, though, I'll still get food stuck and it won't go down. I'll try and eat/drink to "force" it down but all that happens is that I eventually "vomit" everything up. I'm putting vomit in quotes as the food actually never enters the stomach. My major concern, though, is in my inability to vomit. I contracted norovirus a few years ago and dry heaved for HOURS until eventually being taken to the ER and a tube placed in my stomach to get the contents out. What is of major concern is that I've had aortic surgery twice and have a thin aorta, my primary doc says I can't ever heave that way again as I might dissect. I'm so worried as I also like to travel internationally, and if I'm ever on a plane or in a foreign country they might not know what to do. Should I have my Nissen reversed? Who should I see about doing it ? The surgeon who did the Nissen told me if I ever needed to vomit not to worry as it would "come out the other way" but that certainly hasn't been my experience.

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?

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 am a 26 year old female who has had a Nissen Fundoplication and Hiatal Hernia repair done August 16th, 2018.

Backstory/history of reflux symptoms: Prior to the surgery I was having burning in the throat that didn't correlate to what I ate, my incline position while sleeping, or any activities. It felt like I had hot sauce in my throat almost 24/7. This started March-May of 2018. While it was happening, my GI prescribed many different types of anti-acids. The only one that seemed to work was Dexilant. Eventually, I got Cdiff from all these anti-acids. I stopped taking it in May. Ironically, my throat burning went away shortly after. I was tired of taking medicine and didn't want to get Cdiff again so I asked my dr to refer me to a surgeon.

I had a reprieve from the throat burning from mid May-early August. A week before my surgery I started getting a tiny amount of throat burning only after waking up from sleeping. It wasnt happening 24/7 anymore. I decided to go through with the surgery as aided by the advice of my GI surgeon. My 24hr impedance monitor/manometry showed that I did not have any acid coming up, but the surgeon said I still could be refluxing hence the hypersensitivity. I went through with the procedure still as I thought It would make my life better.

Upon waking in recovery, that familiar feeling of hot sauce in my throat came back. The surgeon assured me it was only from the breathing apparatus during the surgery. He also said he found a larger than usual hiatal hernia for someone my age. (This is my theory as to why my throat was burning initially). Within a week after surgery, I regretted having the procedure done. I felt like my issues were more neurological and I should not have been advised surgery. I went to Georgetown Hospital in December 2018 to see if a surgeon there would undo the wrap. He said there was a possibility but I had to re-do all my tests again. Because of the unexplained burning, he wanted to make sure after 4 months that my wrap was still in tact. I had an upper gi, another manometry, 24hr esophageal test, and gastric emptying. The demeester score was lower with the wrap than before yet my throat burning symptoms were more intense. The manometry tube and ph monitor with the wrap caused me to gag profusely. Since the manometry after the wrap, I have had issues with hypersalivation. I constantly am spitting or swallowing, the swallowing causes so much distention that my stomach is bigger after surgery despite having lost 35+ pounds. The gagging during the visit triggered something in regards to my vagal nerve. I have tried Amitriptyline to dry my mouth and calm my nerves and Gabapentin. Both cause my tinnitus to increase and does not do much for the excess drooling. The surgeon at Georgetown did not want to undo my wrap after all my tests came back normal.

Since last week, my chest above my diaphragm where the hiatal hernia was fixed has started to hurt in a similar way to what my post op felt like (lots of dull chest pain followed by tachycardia). In addition, I now have strange gurgling sounds in my stomach after I eat or drink with the lack of ability to pass much gas despite taking Gas-X Extra Strength. I feel like my wrap might have slipped? For the past week I have also been feeling like I've had no appetite. I was 150lbs before the procedure and now I am 110 and still loosing weight as of this last week following the recent chest pains and lack of apetite. Since the hypersalivation, I've been swallowing so much air that gassing through the day is the only way to get relief. Now I am not able to do so.

To sum this all up, I wanted to know if anyone had advice in regards to finding someone who would help augment this procedure? Maybe loosen it up or put the Linx device in instead? Basically, I had a procedure that caused burning In my throat only to have more tests done which caused gagging and then hypersalivation...which then lead to swallowing more air and being so distended that I end up looking many months pregnant. I am living in constant pain, I rarely sleep. The surgery has changed my life. The only thing that keeps me going is the hope this can be undone. I am thinking I was hypersensitive and stressed out before, and then having this surgery has caused some sort of vagal nerve sensitivity. Any advice, thoughts, or comments would be appreciated. I've been hesitant on researching drs and re-hashing my story, it causes a lot of stress.

Has anyone ACTUALLY gotten it and can tell us about it? Everything I have searched for on here is people just considering it but I have not seen one person talk about getting it done and what the results were.

I'm 33 years old, I was 31 when I got diagnosed with a hiatal hernia. I was the picture of health, everyone guessed that I was 20 years old. Out of nowhere, I had acid reflux built up to my vocal cords because of the hernia and it took them 4 months to figure it out. The surgeon convinced me to do a Laparoscopic Nissen Fundoplication, described it as "you'll only be out for 3 days and you'll be eating completely normal in 3 weeks." Sounded like a piece of cake, right?

After 3 weeks, I still couldn't eat anything besides Ensure and Jello, then I researched it and it was more typical that eating struggles were to continue 3-6 months in reality. After 6 months, I really started to panic. Long story short, it's been 2 and a half years since my surgery, and every day I am spitting up something if I attempt to eat it. It gets stuck in my throat. I have phlegm 247 no matter what I do.

I am at the point where I have had every single test done that I can, and the GI is telling me the only thing left to do is reverse it. I am worried about the risk. In trying to research it on my own, I can't even find anyone that has done a reversal to see what I can expect. I cannot live the rest of my life drinking smoothies for every meal.

Aside from wanting my health to improve, I am also wondering about suing the surgeon who make it sound like a no-brainer piece of a cake when I never would have done this surgery if I knew I literally wouldn't be able to eat normally again FOREVER.

Please, if you have had a reversal of a Laparoscopic Nissen Fundoplication, tell us your results.

PLEASE

I had 2 Nissens- yes, 2! First one was great initially however the food thing was a concern. I was told it would take some time before eating could be more normalized--NOT normal! No bread, no rice, and no carbonated drinks. I could not burp, so carbonated anything went away. Over extended time there was some relaxation of the Nissen- my term, relaxation. I could eat more things, but never in large amounts. If I did try to eat large amounts, it would trigger either immediate diarrea action or more often, vomiting. this vomiting relieved the pressure. Even today, many years after those surgeries, I have to be careful about amounts. Why 2? The first one failed. After the surgery, I asked the doc about vomiting- what if I needed to vomit? He said, you can't! Kidding right? No. about 5-6 years post surgery, I became violently ill. I had been extremely careful about everything I ate- if it even looked like it smelled bad, I did not eat it.
The violent illness came with violent vomiting-not from pressure of "over eating". At one point during a vomiting session, I felt a "pop"- end of pressure, shortly later vomiting stopped- maybe some food poisoning-never really found out. Went back to GI doc, long story short, ended up with 2nd Nissen.
Same surgeon-he was surprised to see a case of a second Nissen. All the same pattern as the first. NO bread, no rice, etc. and altho I had tried a couple of beers toward the end time of the first surgery, I just gave up on beer all together. PLEASE KEEP READING.
About 6 years later, same thing with a bad vomiting session and the second one failed. I was meticulous about eating habits; in both cases the surgery fixed the reflux-immediately! And that was great as I read that extra acid in the esophagus was possible cause for Barrets (sp?) esophagus- cancer. Went to a new surgeon for a 3rd Nissen. He said that there was only about a 20%+/- improvement possibility. Did not recommend another. He tested my gut system for emptying--the other end of my stomach and found a delay in emptying which was a problem. said then there were two options- a "pacemaker-type" device implanted to increase stomach emptying capacity- usually worked in his other patients for about a year.
He then shared option 2: stomach removal- called subtotal gastrectomy with roun-Y. Yes, remove the stomach except for a small pouch about the size of a tangerine. I opted for the open time option- gastrectomy. Long and short- reflux permanently cured! No stomach created a multitude of other complexities. Very little food intake possible in one sitting-about 1 cup or combined liquid and solid foods; otherwise "dumping syndrome" took over- vomiting or diarrea. And the volume of food was very small, such that over time Iearned much to my parents' dismay- I could not clean up my plate. One more tortilla chip, one last little bite of any food and I could feel pressure which was painful enough that I went into the bathroom and forcefully vomited. Pressure relieved, all fine. Not so cool on a dinner date! But I have learned to live with it. Would I do it again? Alternatives? Barrets (cancer) of esophagus- no thanks! Had to give up on all alcohol as even a small amount was instantly absorbed and had the effect of a lot more. OK, so I gave up drinking any alcohol- not a real loss. Had adjusted eating habits over time- still run afoul once in a while, but not very often. So, given the alternatives, no thanks on the cancer- that seemed kind of permanent (fatal). Not having a stomach created several unanticipated outcomes- lack of energy, due to reduced food intake; and brutal gas- no locker room funny toots- room clearing gas! Embarrassing! I found a supplement- Devrom- and that took care of it...as long as I took it- chewable 3 x day. Miss a dose- sit on the porch...alone! Devrom is bismuth subgallate- and this is exactly what is needed- not any substitute at all- don't try, or...prep your porch seat! Later in my journey, I found out I had colon cancer- caught it early enough and was able to have it removed without causing the need for a "bag"-lucky me.
So, my 20 year journey has been a journey. I am now 70. I ride a bicycle upwards of 100-120 miles per week averaging 16-17mph. My weight is stable and I suspect that in end things are all right.
Sense of humor? Required! I tell people one more operation and I will qualify to hang on someone's wall!
Patience? Yes, as there were/are times when others around me do not understand my journey. And the explanation was too complex as you have seen- in all, it can be done. Be patient; be forgiving, be diligent. Your journey may not end up as far along as mine- but you may well have a journey. Feel free to contact me directly if you need; or anyone reading this can. I hope this gives you some insights.
Take care.

I had a hiatal hernia repair with toupet fundoplication in April in Dallas. Presurgery symptoms consisted of 1000s of burping and acid leak into my throat at night. Now post surgery, there is a constant cacophony of gurgling sounds in my stomach, stomach bloat with any food, the acid has returned, throat feels raw, flatulence is round the clock, I experience daily bouts of very severe epigastric pain in the upper abdomen or so I think it is. I now suffer unexplained dizziness whenever I bend down suddely. I am more miserable now than before the procedure. I am seeing the surgeon in a couple of days would want to discuss a reversal, kinda want to know if anyone had gone through this and what worked or didn't work.

The surgeon wanted the LINX augmentation procedure or TIF. He said Tricare would not cover the procedure for service members, narrowing the options to Nissen or Toupet fundoplication. I settled for the toupet based on the explanation that I can still burp and or vomit as compared to the Nissen.