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Nissen Fundoplication

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GERD & Acid Reflux
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Posted 9/10/2010 4:46 PM (GMT 0)

Hello,

 

I spoke to a surgeon yesterday about surgery for my GERD.  He has recommended the Nissen fundoplication.  He gave me a brochure and set me up to have several procedures done.

 

My concern is that I have read so many stories on this forum where people complain of neck/chest pain afterwards and lots of fatigue.  I am getting nervous now and wonder if the surgery is worth it.

 

Has anyone had a good experience?

 

Thanks,

Posted 9/10/2010 6:09 PM (GMT 0)
Hi,

 

I too would like to know more about this procedure.  Is it true that you are not able to vomit again after this procedure?

 

Nolique
Posted 9/10/2010 6:20 PM (GMT 0)
Had it done. No neck or chest pain. No fatigue from that.

There are real side effects, like some of us can't burp. But even that goes away for many. It's a 3-month recovery, and during the first couple of weeks it isn't fun. But most of us are very happy we did it and would do it again.

The key is to find a surgeon with a few thousand patient experience and a great success rate. You'll probably end up in a large teaching hospital to find a really world-class surgeon. Start by asking your gastroenterologist!!! I see you are already seeing a surgeon, but was he highly recommended by your gastro or pcp?

Yes, do go through the tests. They're not fun, but they are very necessary to figure out if you really need the surgery, and if so, what procedure is best for you. If your surgeon only does one procedure, you should probably look for one who has experience in more. My case, for example, was difficult. I had a good bit of my stomach stuck in my chest, so I needed that brought down, then a bit of esophagus dissected down so there was enough length for a wrap, and finally, a partial wrap because I have a very weak swallow. I wouldn't have been able to push food past a full wrap.

I was scared to death. I looked up everything I could find on the different procedures, tests, and even on my highly recommended surgeon. I watched a bunch of procedures online and educated myself. I have a lot of co-morbidities, so I was not an ideal or simple case. I'm a lot better off than before surgery.
Posted 9/10/2010 7:20 PM (GMT 0)
I had the Nissen done Jan 18, 2010. I have no problems at this point. I would not go into the surgery lightly. As any surgery, it can have complications. I had a hard time with the liquid diet, but some doctors don't require it for so long. I felt pretty good once I was able to get back on soft foods. I believe if this is a surgery that you need, then it will certainly be worth the trouble.
Best of luck to you!
Stacey
Posted 9/10/2010 9:39 PM (GMT 0)
GERDA and Nolique,

Welcome to HealingWell.  There is much info in the forums here re this surgery.  I think you have to do your homework well,  find a physician you trust and make an informed consent to choose the procedure for yourself.  Remember each person is different and no 2 people will have the very same recovery. 

According to Mayo Clinic, about 90 percent of people are heartburn-free one month after anti-reflux surgery, and more than half have no symptoms 20 years later. Although long-term surgical results are generally very good, some people eventually may resume taking medications and a few may need a second operation.

Swallowing problems are common after surgery, but usually improve after the first few months. Other side effects that can occur include difficulty belching, bloating and diarrhea.

Only you can make the final decision after you have gathered all your information.  Don't hesitate to get a second opinion if you are not feeling secure re surgery.

Kindly,

Kitt

Posted 9/13/2010 12:45 AM (GMT 0)
Hi GERDA,
Welcome to the GERD forum! I had the Nissen surgery in February 2009. I had it because the reflux I had was causing uncontrolled asthma. I avoided the surgery for about four years, during which time my asthma and family doctors encouraged me to consider it. They weren't able to control my asthma because acid was refluxing into my lungs and keeping them in a state of inflammation.

I was afraid of the surgery, as I'd read all kinds of scary posts online when I researched it. In the end I didn't really have a choice. I was in bad shape, and my lung condition was life threatening.

I thought the recovery would horrific and that I wouldn't be able to eat for months. I was afraid that the surgeon would do damage and make my condition worse. In the end, I found this forum and talked to others here who had experienced the surgery. They were very encouraging, realistic, and positive about the results.

I wish I'd had it done sooner. The recovery is not anything like I expected. I was on liquids for the one day I was in the hospital, then on soft food until Day 5 when I saw my surgeon. After that I was able to eat anything at all that could be chewed to a liquid.

The recovery is challenging in the early weeks, but not as bad as some of the GERD/reflux episodes I'd had before the surgery. Once you get past the swelling, things go very well. It is very "doable" though...very little pain...yes you can get gas pains in your shoulder, but if you get up and walk regularly, that will be alleviated. My nurse in the hospital the first night said to get up and walk whenever I went to the bathroom, which I did. I walked at home, too. I found that the amount of shoulder pain was increased when I didn't walk, and went away when I did.

The main thing you need to do, should you decide to go forward with surgery, is to select a highly skilled surgeon who has done many successful Nissen Fundoplication surgeries. I heard the number 300+. I went to a teaching hospital, and made my surgeon promise that he would be the one to do the surgery, not his resident. He said the resident had to help, but he would do the actual surgery. I was fine with that.

If you're considering surgery, you should have a
Barium Swallow
Manometry
24 hr PH monitor
Endoscopy
Maybe a stomach emptying test to ensure you don't have a motility problem

If you truly need the surgery, go for it, but do so with your eyes wide open. Surgery should never be taken lightly. However, if you need it, you have no need to worry, as long as you have a talented and experienced surgeon doing the work.

Good luck with your decision. If you have any other questions, ask away!
Take care,
Denise
Posted 9/13/2010 12:50 AM (GMT 0)
Hi Nolique,
I will try to answer your question regarding the ability to vomit after surgery.

Many people cannot vomit after surgery, and will simply have dry heaves. Eventually everything goes out the other way.

Because of this, people who have had the surgery always have anti-nausea drugs on hand to stop the urge to vomit.

That said, there are some who've had the surgery who find they can vomit. I'm one of those.
It's very dependent on the tightness of the wrap. Most, though, (including myself) avoid vomiting if at all possible due to fear that it might damage the wrap.

Hope that helps. If you have any other questions, let me know.
Denise
Posted 9/13/2010 4:29 PM (GMT 0)
Hello Everyone,

I just joined this forum. I am schedule for surgery on December 21st because I work for a university and will have 3 weeks off for winter break. I have been a little nervous as well about the recovery and also because I am generally a really active person.

I am planning to go back to work after 3 weeks for the start of the new semester, as I teach and advise. Has the 3 weeks off been enough for others?

I have had all of the testing done -- and ultimately, surgery is my only option because my valve is so weak. My doc said normal adult valve pressure is around 35 and I am 5.4.

I just really want this to go well. Currently, just hitting a pothole while driving can cause reflux.

Thanks.
Posted 9/13/2010 11:14 PM (GMT 0)
I had mine over Christmas break. Two weeks were do-able for me. I'm a teacher, too.

Just remember don't lift anything over 5lbs for six weeks.
Posted 9/14/2010 12:39 AM (GMT 0)
Joy I see you say not to lift over 5lbs. for 6 weeks my surgeon just told me nothing over 20lbs. for the first two weeks.
Posted 9/14/2010 12:49 AM (GMT 0)
My surgeon was very strict about the post-surgery diet and exercise.
I know if I tried lifting 20lbs during those six weeks I'd been hurting horrible. At three weeks I pushed a 15lb desk across the floor six inches and hurt for two days after.
Posted 9/14/2010 2:58 AM (GMT 0)
Thanks, Joy. That is good to know. I have a briefcase on wheels and should be able to avoid stairs. I do have to park a good distance away. Will walking pulling my bag for say 5-10 minutes be possible at 3 weeks out?

Sharlene
Posted 9/14/2010 10:35 PM (GMT 0)
How heavy is the briefcase?
If you don't use your stomach muscles it might be okay.
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