paraesophageal hernia surgery out of state

I did it twice. Both surgeries were in Maryland, and the first time I was living in California. Now I am living in Georgia.

If you have the lap procedure, you should be prepared to stay locally (preferably with somebody to drive you around) for 2 weeks. Both times, I was cleared to return home after those initial 2 weeks.

You'll be able to continue follow-up through a local gastro, and e-mail/phone the surgeon after about 4 months. I had (and have again) directions to return to the surgeon at approximately 1-year post-surgery.

Returning to California, I used air travel. I used a wheelchair in the airport, and brought Ensure with me for nutrition during the trip. At that 2-week mark, you should be off narcotics and cleared to drive yourself.

Returning to Georgia, my parents and I drove, splitting the trip to 2 days just because sitting so long in the car was uncomfortable. If I have to do it again, I would choose to fly.

Having had 3 Nissens now, I would highly recommend against the open procedure for a first time hernia repair. From your other posts, it sounds like yours is a type IV, which is much more likely to recur than other types. Once you go open, you'd be hard-pressed to find a surgeon who would then do a lap procedure. If you start with a lap, you'll find a small group who will try another lap -- and have the option to go open.

Good luck!
David

Thank you Alice and David. The surgeon that said he would only do an open thoracotomy IS from a large medical center at the University of Michigan. He is very well known, as I have researched my condition. He has done just under 2000 of these surgeries and won't consider doing a lap procedure. When I asked about it, he had a visible reaction, and said absolutely not. His nurse told me that people come from all over the world to have him do this surgery. I probably won't find anyone else in Michigan that is more experienced with this type of paraesophageal hernia.

Yet, I just don't want to be cut open. I would so much rather have a it done laprascopically. But I would probably need to go out of state to find a surgeon that has as much experience. And this surgeon told me there would be less chance of a reoccurance if I had it done open. He said a lap procedure usually gives a higher reoccurance rate.

It's so hard to know what is right. I appreciate any and all insights and experiences and advice.

Deb

Cuicui -

Yes, he was the surgeon of record. Of course there is at least one assistant, probably more, also someone who sets up everything, starts the surgery. The big doc comes in to do the tricky parts.

In my case there was quite a lot of dissection needed in the mediastinum to bring down enough esophagus to be able to do the wrap.

"Dr. Luke" has a fantastic reputation, but I would trust a few of his minions to do the whole thing too, particularly Dr. Levy. They both explained a whole lot to me and though they are horribly overworked when they go to their "clinic" in the hospital, I felt they spent enough time talking to me. I am not uneducated, degree in biology, worked in ICU at that hospital, worked in pharmacology research. I pretty much knew what I needed, but they detailed exact type of operation and how they were going to do it - lap, with possibility of having to go open or at worst thoracotomy.