I had my first nissen done at mayo's in 2010. I had nothing but misery. Mayos didn't want to do anything to help me AT ALL and said it can't be taken down. My second was at johns Hopkins's after they said the first one failed. Again same problems. After 8 years of suffering I finally got it taken down successfully 10 days ago in Juarez Mexico of all places: The NIH (google their website since I cannot post the link here) recommends that failed nissens can be taken down for a Roux en y bypass and therefore acid reflex is also still eliminated. ( the link to their website is up top ) it's only been a week but I feel like a new woman! All the top hospitals in America couldn't help me. It seems in the bariatric world they take down nissens quite often and are very familiar with it. Thoracic surgeons and bypass surgeries need to combine their knowledge. Dr. Rodriguez is board certified in the US But obviously it is cheaper for American patients to do it in Mexico if your insurance will not cover. And he does more than anyone in the United States. higher numbers means less complications. Best of luck!