Had giant paraesophageal surgery

I had surgery at the UPMC on January 30th for my giant paraesophageal hernia. I live about 5 hours away from Pittsburgh, but researched my options and chose, who I thought to be, the best possible surgeon. The surgeon and I had spoken by phone months before the procedure, and I sent him an email a few weeks before, stating some more questions and some of my main concerns. I was most concerned about automatically getting a wrap (nissen or toupet), as I had no real symptoms of reflux and felt the wrap could possibly create more problems than it would help. Every other surgeon said that they only did the repair with a wrap. But, I am happy to say, that I had the giant hernia repaired using a gastropexy instead of a wrap. I was placed on the nissen diet for the first 6 days (3 days clear liquid, 3 days full liquid). At my follow up appointment yesterday, I was told I could go back to a normal diet, which I have done. At one week out, I am very pleased with the results. I am back home now, and feeling good. I still tire easily, and a few of my incisions still hurt a little. But all in all, things could not have gone better. I developed a Pleural effusion, so ended up in the hospital an extra 2 days. But I had great care by the nurses, and an all around good experience.

Congrats cuicui!

For those who are unfamiliar with the procedure, here's a good study from Cleveland Clinic with diagram:
http://ccjm.org/content/70/6/511.full.pdf

Sorry this doesn't come out clickable. It doesn't have a www. You have to copy and paste.

made it clickable...

Post Edited By Moderator (dencha) : 2/7/2013 8:33:38 AM (GMT-7)

Southern Gal,
A little of my background. My diagnosis of a giant paraesophageal hernia was a complete surprise to me, as I had few, very mild, symptoms. Really the only things that developed over time were a slight wheeze when I laid down, and some very occasional left sided pain. I went to my GI doctor and after testing found the giant para. I have had this a very long time, at least 10 years, if not longer. They also discovered Barrett's esophagus at the same time. Again, no symptoms and no reflux pain at all. I researched for almost 1 year before choosing the surgeon to handle my para. I met with 4 other thoracic surgeons, and they all said they could do the surgery, but 3 of them said if I wanted the most experienced surgeon, I would use the guy in Pittsburgh. That's what I did. I fully expected I would end up with a nissen wrap or at least a toupet wrap. I wanted neither one. Remember, I had no reflux symptoms, so I knew I would end up with more side effects than I had before surgery. When I met with my surgeon before my procedure, he suggested I was a good candidate for a gastropexy, which means after he brought down my stomach and colon, he anchored it to the diaphragm, instead of doing a wrap and anchoring it to that. When I asked if I should have a wrap because of my barrett's, he told me that research did not back that up, and that because I hadn't had normal anatomy in a long time, he felt it would be more prudent to see how my body reacted first to a more normal anatomy. He said he would check my esophagus during surgery and see if it would be long enough to have a wrap, should I ever need one (it is long enough). I just saw my local GI doctor for follow up after surgery and he agreed with what the surgeon said and did. Of course, I will continue to follow up on my Barrett's and seek treatment for that. And I am curious to see what happens now that my stomach and colon are back where they should be.

You asked about recovery. I spent 4 1/2 days in the hospital because I developed a pleural effusion and had to have a drain put in. But my recovery from the procedure itself has been great. I used pain meds only 1 day and 2 nights. I was up walking the next day, and felt pretty good. I was on a clear liquid diet for 3 days post-op and a full liquid diet for the next 3 days. After that, the surgeon told me I could go back to a normal diet, which I have done and feel great. My esophagus was not changed in any way, so swallowing is perfectly normal. I am a stay-at-home mom, so I am back to my normal life, except I am still restricted with driving and lifting heavy things. I never had trouble swallowing and still don't.

If you have any other questions, please feel free to ask.
Deb