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Mon, Feb 3 9:13pm · Post-Nissen Fundoplication Problems in Digestive Health

@marychapman @sickvick @fourof5zs @leannesalinas @pdilly

Hello All,

I wanted to post an update since I saw the surgeon a couple weeks ago. He said that after reviewing the CT scan, the Nissen wrap itself hasn't moved, but a small portion of the stomach has been pulled up through it. While the only way to fix this is through a second surgery, he told me that currently there is no danger to leaving everything as is. The risk of complications goes up from 1-3% with my first surgery to 5-10% with a second. Since they would not know why the stomach was pulled up (shortened esophagus from scarring or just a result of the small hernia), the surgery could end up even more complicated if he would have to remove part of the stomach to lengthen the esophagus. There is a greater chance of bleeding with the liver or spleen. He said that while liver bleeding is very easy to stop, the spleen is a very tender organ and it can be more difficult to stop bleeding, which can potentially lead to it needing to be removed. He also said that the chance of long-term side effects such as difficulty swallowing, inability to burp, and more limited diet could result. Finally, the recovery would be longer than the first surgery. He told me that I would have to weigh the amount of discomfort I am in right now with the potential risks.

I have opted to not have another surgery at this time. While I still have some spasms and heartburn, I consider my current symptoms very manageable. Should the hernia get bigger causing more of the stomach to move up or the symptoms become significantly worse, my surgeon said that he will always be there and we can schedule surgery whenever I want to.

I hope that this helps some of you.


Mon, Feb 3 9:13pm · Post-Nissen Fundoplication Problems in Digestive Health

@sickvick I am so sorry to hear of all of the trouble you have had! I had relative success for the 7 years the wrap was in place. I do have trouble with spasms which can be very painful. I am just anxious to find out whether surgery is something I am going to HAVE to do. I will definitely post an update when I hear.

Mon, Feb 3 9:13pm · Post-Nissen Fundoplication Problems in Digestive Health

@pdilly @fourof5zs @sickvick Okay, so here is an update. I get so incredibly frustrated with how hard it is to get someone to return a call. After a week of no word from the gastroenterologist about my CT I called. They took a message because they said it was an hour phone wait time to talk to anyone. This was Tuesday. Thursday I sent a message through my health portal explaining that I read the radiology report and I understand what is wrong, but I just wanted answers to three questions:

1. What are the implications of the slipped Nissen?
2. If this something that HAS to be fixed surgically?
3. If it does, what surgeons do they refer to?

Got a voicemail message earlier today from the doctor saying, "This is Dr. [removed]. I just wanted to see if you have any questions about your CT results. We would refer you to Dr. Larry Stevens [he did my first surgery] who I think is still practicing in Indianapolis. If you want us to schedule the appointment, let us know."

So…the long and short of it is that I took it upon myself (I am not waiting for anyone else to do anything I can do myself!) to make an appointment with Dr. Stevens for Friday, November 16th. I will say that I had a wonderful experience with him with my first surgery. At that point he had done almost 1,500 Nissens with a 98% success rate. What is frustrating is that I still don't know if I was referred because I will definitely need surgery — was I referred because they aren't sure if I will need surgery? Now another 2 week waiting game, but at least I will know when I leave his office on the 16th what the path forward will look like. I will continue to update. I know that I appreciate reading others' experiences, so others may benefit from reading mine.

Mon, Feb 3 9:13pm · Post-Nissen Fundoplication Problems in Digestive Health

@fourof5zs Normally my partner would come with me, but is out of PTO until after the first of the year. I am going to write all our questions down before I go so that I am sure not to forget anything.

Mon, Feb 3 9:13pm · Post-Nissen Fundoplication Problems in Digestive Health

@leannesalinas I wish I could offer you the insight that you are looking for. I wanted to reach out to you, at least. I had my Nissen done 7 years ago. Recently a CT scan showed that the Nissen has slipped and I have a 4.2 cm hiatal hernia. I was also referred back to my surgeon from the original surgery. I see him on the 16th. I am anxiously waiting for answers too! If you haven't already, take some time to read through the discussion called Reversal of a fundoplication. While it's not exactly your situation, I found some helpful information reading through peoples' experiences and information. Good luck!

Mon, Feb 3 9:13pm · Post-Nissen Fundoplication Problems in Digestive Health

Hello Everyone,

I had a Nissen fundoplication done 7 years ago. It worked really well. If anything, I had to be sure to take smaller bites and drink liquids with every meal to make sure everything made it down to my stomach, so nothing was coming back up! In the last 6 months I started having pain behind my left ribcage and two instances of horrific waves of pain below my sternum that would go all the way around my back. An endoscopy shows slight inflammation of the stomach lining, but biopsy showed no infection. They did an abdominal CT with oral and IV contrast last Wednesday. I was able to read the radiology report on Friday.

"New small 4.2 cm hiatal hernia since previous upper GI on 11/10/2016. The appearance is compatible with herniation of the area of fundoplication."
"Impression: New small hiatal hernia since 11/10/2016 . The herniated portion of the stomach appears to represent the area of fundoplication (slipped Nissen)."

I am still waiting to hear from my gastroenterologist, but I am worried that I will have no choice but a revision surgery because I have read it can be dangerous to leave it. Has anyone else had any experience with a slipped Nissen?