How does a Nissen work?

I know the general basics of a Nissen....

But does the sutures only hold temporarily while "scarring" of tissue occurs which holds the wrap in place?

I'm just trying to understand the procedure. Does the scarring inside make the wrap better over time vs. only the sutures?

Thanks.

Hi Max,

When the stomach is wrapped and stitched, it creates pressure on the LES and strengthens its ability to stop acid from refluxing.

I found this quote which seems quite simple to understand:

"Then, whenever the patient has something in his or her stomach, the pressure generated is transmitted to the collar wrapped around the esophagus, compressing the esophagus further.

"Therefore, the more pressure inside the stomach, the greater the pressure inside the esophagus."

For a fairly common procedure there's not a lot that really explains the way the wrap actually works.  My surgeon told me that more than a valve, the wrap is a one-way flap that lets food and drink in but stops things from leaving the stomach and entering the esophagus.

I believe the stitches stay, but the scarring/healing of tissue is what gives it the strength it needs to withstand all the pressure we put on it both with moving and eating.

The reason it starts working better after healing progresses is because the swelling recedes and the wrap settles into place better.

Hope that helps.

Denise

Max,

You're very welcome.  Have a good day.

Denise

 

Max,

I did not feel any improvement at all, and then, seemingly overnight (at about the 2 and a half mark) my lungs improved.  It was even during peak allergy season.  I was amazed and surprised.

Hang in there!

Thanks Jesper.

How are you doing these days?

I hope at the two month mark my symptoms fade as well...

I know the wrap is still secure as I still have some difficulty eating soft foods. I tried some fish today and in the beginning it went down easy but later I could feel it getting held up and I started to hiccup.

I don't mind this but I hope the burning in my throat/mouth subsides... :(

Here's a long, detailed article on the different types of repairs available, testing, etc.
http://www.nature.com/gimo/contents/pt1/full/gimo56.html

Hi Max,

I think it was a combination of the wrap settling into place and my lungs having a chance to heal without being inundated with reflux that continually inflamed them. 

Denise

Well my regurgitation and post nasal drip has actually subsided a lot, for which I am quite happy. It was annoying as hell!
My throat, hoarseness, globus feeling, constant throat clearing and mucus in the throat are not doing so much better though. I have just tried for the fifth time to cut back on PPI’s and I think that it is partly the reason for why this is still giving me problems. I have given up on the cutting back for now and are back on 30 mg. Lasoprazole twice a day

I like you suspect that maybe the op did not solve everything. As I told earlier I actually had a 2 week period where everything got a lot better but that is 6 weeks ago now.
Now I am week 18 and my surgeon has told me to give it another two months and then we will go through all the checkups to see if there if everything looks and works right. At least I doing better on a couple of the KPI’s, which is better than nothing :)

No reason to freak though. It is how it is and if it needs a tightening that is what we will do. If it is a perfect wrap we will look at other options.
Have you tried the Kaufman diet? You should be able to do the introductory diet at this stage in your recovery