Surgery options for GERD

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paris1951

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Hi, I'm new here. I've had GERD since last July, had an endoscopy which showed a small hiatal hernia. I'm on Prevacid but I'm in pain all the time, can't eat much, losing weight (I'm already skin and bones), feel like I can't breathe, can't sleep much, am miserable 24/7. I hate the thought of living like that. I'm contemplating esophyX. I'd like to hear your experience if you've had that surgery. Thank you.
 
Hi,
Anyone have info on or experience of GERD surgery. I have a hiatus hernia and am at the point where I'm so tired of years GER, and it getting worse, affecting sleep, affecting social life, etc., that I am considering surgery. I've tried everything that has ever been suggested, with no success except drugs, which seem to have lost their effect. I have heard there is a laparoscopic one, with smally incisions. I'm told the success rate for this type of surgery is low, so would like to hear from anyone else on this.
Scozzie
 
The surgery is called Nissen Fundoplication. It can be done laproscopically with 5-6 incisions. It involves wrapping the upper part of your stomach (fundus) around your esophagus and stitching it to itself. As a result, every time your stomach contracts, it contracts around your esophagus, thus preventing the acid from coming up.

This is a serious surgery and before a doctor considers referring you for the surgery, they should ensure you have exhaused all other options. The surgery does have a good success rate for GERD, but it isn't 100%. My internet research indicated 80-95% on average. As you can see if you do a search on this board, there are some that it has helped and others who regret having the surgery.

I had the surgery about 8 weeks ago. So far, I have had some success, but my digestive system is still settling.
 
I felt like you do until I had my nissen in Sept. Although I don't feel near 100% anything is better than the way I had been. I don't know much about esophyx and tried to do lots of research before choosing nissen. Doctors were not even talking about esophyx with me. If I were you I would definitely consider some type of surgical intervention. Good luck.
 
Inspector: Well said, this is NOT a simple surgery by any means. I am a dentist, so had a pretty good idea what was involved from a technical standpoint. I have had a neck surgery, and two other abdominal surgeries. I am not aware of your age ( I was about 38 at time of the Nissen, am 49 now ). In general I find surgeons routinely underestmate healing times. If you are middle aged and having abdominal surgery (Laproscopic, open surgery would be longer healing) I allow 4-5 weeks off work. Two weeks back to work after a Nissen is unrealistic for most people.
Yes, I can vomit. I do suffer from gas/bloat occasionally even now. After the Nissen I was not comfortable after eating for approximately three months.
For me the surgery was not very effective at all, but I know of people that were very happy with results. My surgeon would not have done the Nissen without a mannometry and 24 hour PH probe.
Greg :dizzy:


inspectormoe said:
gaugreg1x, I think the surgery is over sold as a simple easy fix. I know when I was contemplating the surgery I was handed a comic book style information booklet that really down played the complications. It said (as well as the surgeon) I'd be back to work in 2 wks, and shortly afterwarRAB be living a normal life. From my experience with others who have had the surgery, it is a rare person who heals that fast. I went back to work in 7 wks and it was hard even then but we all heal at different rates. I didn't get some relief until after a year of recovery.

Are you able to vomit? I still can't even with the screwed up fundo which is very painful when the stomach is sick. That alone is a big factor.

How long did your fundo last?
Click to expand...
 
I had the surgery 9 weeks ago. Overall I would consider it a success. My acid reflux had caused a chronic cough, hoarseness, and frequent regurgitation. The surgery corrected these symptoms. The recovery obstacles that I am encountering are related to a diet that works, but I am sure that with time and patience it will improve. I do not regret having had the surgery.
 
I am scheduled for the Nissen procedure on January 20th. Unfortunately I was unable to tolerate the esophageal manommetry test. So I am not sure if the surgeon will even be able to do my surgery as he will not know how tight to do the wrap. Has anyone had the Nissen procedure without having the esophageal Manommetry test done first?

I also have been doing research on the EsophyX procedure. I found out that my insurance does not cover it.
 
I agree with you totally. I was 55 when I had the surgery and now I'm 60 which snuck up on me :) I know the surgeon's I've seen (4) not one would consider surgery without the PH and manometry as a minimum. Even to do a take down they still wanted the same tests which seemed odd to me.

I cannot vomit and it is very uncomfortable when I get a stomach bug. Until the body figures out it has to void the bug another route, it isn't fun. Has your wrap failed so you are getting reflux again? Are you planning to just live with the results? I'd love to have a take down but the thought of surgery scares me as it can always be worse :)
 
I could not have said is better Inspector, this is not ot be entered into lightly. I had my Nissen about 10 years ago and the relief was very short lived. Although I did not have any complications other than gas-bloat.
Greg
 
I had a Nissen several years ago and only had relief for 2 months. It was so disappointing to have the heartburn return. As someone else said though, some people have successful GERD surgery. Good luck to those who have it.
 
gaugreg1x, I think the surgery is over sold as a simple easy fix. I know when I was contemplating the surgery I was handed a comic book style information booklet that really down played the complications. It said (as well as the surgeon) I'd be back to work in 2 wks, and shortly afterwarRAB be living a normal life. From my experience with others who have had the surgery, it is a rare person who heals that fast. I went back to work in 7 wks and it was hard even then but we all heal at different rates. I didn't get some relief until after a year of recovery.

My fundo is disrupted according to a well known surgeon so all the effort to reduce reflux is basically gone. I am not willing to have another fundo but I have considered a take down. Are you able to vomit? I still can't even with the screwed up fundo which is very painful when the stomach is sick. That alone is a big factor.

How long did your fundo last?


RSApooh, I have not had the personal experience of a fundo w/o a manometry and I would be cautious. The test is no fun but it is an important tool to assess whether you are a good candidate for the Nissen. If you have swallowing issues pre-surgery, they will only be worse afterwarRAB as it takes a good esophagus to push food etc through the wrap. Don't rush into the surgery assuming it will all work out. If you haven't tried all the other alternatives do that first, the surgery can always be done later. Remeraber once the surgery is performed, it is basically permanant. I'm not trying to discourage you as the surgery has helped many people. Just be aware of the downsides and do the research including other procedures. Keep us posted on your progress :)
 
Make sure you have tried all alternatives for reflux control as the Nissen is life alterning surgery, whether for the good or less than desireable results. The complication rate runs 25%+ so fairly significant but that being said, it has helped many people. I am at the 5-1/2 yr mark and unfortunately I fell into the 25% group that experienced problems.

There is also the Hill Procedure that appears to enjoy a success rate for reflux control comparable to the Nissen and seems to be less disruptive of the digestive system. For some reason it doesn't seem to be as popular.

Do your research and ask LOTS of questions of the prospective surgeon. The outcome is highly dependent on the surgeon's skill level so chose wisely.

Good luck with your decision! :)
 
I don't know if it has failed persay, it just has never worked that well
in controlling my reflux. Greg
 
Sorry to hear the wrap hasn't worked that well especially after enduring the trauma of surgery. My wrap is "disrupted" the surgeon told me, so whatever that means. I think one of the G.I.'s I saw ruined it. I was having difficulty getting food through a tight wrap so they dilated it "significantly" he said, while I was under for a scope. I have never felt such pain in my life afterwarRAB so I think he tore something which other doc's seem to agree. Since that time it hasn't worked well but like I mentioned, the thought of re-surgery scares me. Do you still get reflux?

Steve
 
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