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Questions regarding Fundoplication

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GERD & Acid Reflux
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Posted 1/27/2012 3:08 PM (GMT 0)
Thanks all i want to say for the great community here helping each others out.

I have a few questions regarding surgery for Hiatal hernia, after i met my doctor the analys came back from the GI doing the endoscopy on me, he said that i had a "large" hiatal hernia".

When i had GERD 20 years ago i was diagnosed with Hiatal hernia as well after endoscopy, however they didn't say if it was small or large.

Anyway, will Hiatal Hernia always be present in a body if you already have it?

In my case lifestyle changes have done miracle as it did 20 years ago, i lost all weight needed and eat properly, yes it's boring life but it makes me feel 90% good of the day... turn

The GI told me that he could tighten the LES a little bit if it was necessary but they didn't recommend it as it needs probably to be redone after a few years.

If you look at statistics, how many of patients who have done fundoplication has needed redone again or even a third redone?
Posted 1/27/2012 3:20 PM (GMT 0)
Hey lanab --

Just wanted to make a quick point about the statistics for the longevity of fundoplication surgery, that it's a "moving target" and difficult to quantify. The reason is that surgical methods have improved during the years, but it's not always clear if the statistics sort out which group patients belong to. Initially, fundoplication was done as an open procedure, and these surgeries don't have quite the long-term success as the newer laparoscopic ones. But, over time, there's overlap between the two groups of patients...early on, there were still more open procedures, then, more recently, more laparoscopic ones.

Also, there's a correlation between the relative skills of the surgeon. One surgeon may have developed some fabulous techniques as a result of doing many, many procedures, and have an incredible long-term record. But when you mix those statistics into the whole pool of results, it dilutes the good results, and hides some important details.

Statistics are slippery things, but they're our only tool for measuring things we want to quantify.

-Bruce
Posted 1/27/2012 3:22 PM (GMT 0)
If 100 people have Nissen done, how many of those needed redone? would you say 80? i just want to get some perspective what i am dealing with as i am meeting up with my GI next week and want to be ready for questions.
Posted 1/27/2012 3:38 PM (GMT 0)
Good Morning,

I so agree with you re what a great community this forum is. I have found the support, validation and encouragement that I receive here, to be so helpful and healing.  Thank you for your kind comment.

Here is a link to an article re stats that you may find interesting:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1357166/

 

Posted 1/27/2012 4:01 PM (GMT 0)
lanab-

This isn't stats, but my last 2 surgeons did tell me they expect their nissens to last between 10 and 20 years barring anything strange happening. I had a strange happening that caused me to have the 2nd redo. What had to be done to repair my torn esophagus tore my wrap apart.
I agree it depends on how skilled the surgeon is.

Take care,
Bill
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