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Failed fundoplication x2

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Posted 8/1/2013 5:20 PM (GMT 0)
Hi,

Looking for some advice. I have had 2 failed fundoplications. My first was may 2011 I had a 270 degree wrap which failed to onto my symptoms and despite high dose medication I continued to be Ill. I then had a 180 degree wrap April 2012 which failed to control symptoms and 6 weeks post op on high dose medication I had a detester score of 46. Over 1 yr on symptoms are getting worse and worse - nausea, heartburn, general fatigue, feeling unwell despite being on a stack of medication. I think the wrap has probably loosened over past year. What's next? Should I just put up with it? Further fundoplication or radical surgery such as gastrectomy with roux en y? I'm getting pretty fed up of it. Please, if anyone as similar experience or advice it would be gratefully received.
Posted 8/1/2013 10:18 PM (GMT 0)
Are you having local surgeons perform the surgeries?
Posted 8/2/2013 5:02 AM (GMT 0)
Yes, same surgeon did both but he is an expert in fundoplications and has done many!
Posted 8/2/2013 8:08 AM (GMT 0)
Hi Gaviscon99, so sorry to hear your still suffering after Two nissens. Very demoralizing to be in your situation. You have to question the surgeons skills here? What is your surgeon saying about the failures and why did you have partial wraps? Do you have a motility problem? Is it possible for you to get another opinion. Barry
Posted 8/2/2013 9:39 AM (GMT 0)
Hi,

First wrap came didn't work but reduced demester score from 100 to 48, but the endoscopy undid wrap! Second wrap made no difference! They don't understand why not working cos barium showed very tight wrap but ph studies shows severe reflux with demester score of 46, and that was 6 weeks post op! Surgeon is very highly thought of, done alot of research into reflux and works in tertiary centre so he gets referrals from people less experienced! I have contacted a professor who advised if wrap cannot be adjusted the gastrectomy with roux en y may be option!
Posted 8/2/2013 10:07 AM (GMT 0)
Hi, I still don't understand your surgeons choices,im no expert in surgery but why do a 270 wrap which failed then reduce the wrap to 180? Also the your first wrap must not have been very secure if an endoscopy undone it. I would definitely look for another surgeon for another opinion. Barry
Posted 8/2/2013 10:39 AM (GMT 0)
Reason for 270 was ment to have good results and less side effects compared to 360. 180 was done cos 270 had come undone! As I say, wrap was very tight initially as couldn't swallow for a week and was admitted to hospital! I don't fully understand reasons why these decisions were made! I am now in tricky position cos each time further fundoplication is done less chance of it being successful! Obviously surgeon doesnt want to do irreversible procedure like gastrectomy unless there's no other option! My symptoms may be clouding my judgement but I think I am heading that way. Anyone had more than 2 fundoplications and had success?
Posted 8/2/2013 12:29 PM (GMT 0)
hi,i have had two surgeries myself.I had a 360 nissen done last year and nothing but problems ended up back in hospital approx. 3 months after for a redo where they undone a couple of stitches at the crural repair,total nightmare.Im still not well,just seen another surgeon who says I have a motility problem and doesn't want to operate again because ive had two previous surgeries.Too Risky!
Bill,one of the forums moderators has had three surgeries and hes ok now,so there is hope! Barry
Posted 8/2/2013 2:20 PM (GMT 0)
So what's the plan with you? What symptoms have you got?
Posted 8/2/2013 2:49 PM (GMT 0)
Don't know what to do,ive to see the surgeon in person next month to get a more detailed report of his tests he carried out so I will take it from there.I was hoping he would try a 270 wrap but from his letter he doesn't want to take any chances.
Ive constant nausea,feelings of reflux though ph test was negative? Generally feeling rubbish and back on meds with all the side effects they bring.
Im going to keep looking if this surgeon doesn't help because this is no way to live. thanks Barry
Posted 8/2/2013 3:42 PM (GMT 0)
 

Sounds like your having a pretty rough time too. I get severe morning nausea, sour taste in mouth, overwhelming fatigue, belching ++, heartburn, severe intermittent nausea. Your right, its not a good way to be.

I am in the Manchester area and there are a few local experts so i think I am going to try and see them and see what they say. every time I have seen doctors they just want to wait and see - which is understandable given the poor luck Ive had with operations so far.

Posted 8/2/2013 3:42 PM (GMT 0)
Gaviscon99

I am confused about going from a 270 to a 180 myself. I have had 3 360 wraps and would be on my 1st redo if I hadn't had an esophagus tear and what needed done to save my esophagus tore apart my wrap. I had it redone a 2nd time on 8/24/11 and all is good.

I would definitely get a 2nd or 3rd opinion.

Do you have a swallowing issue that played a part in your surgeon deciding in the 270 and 180 wraps? If not I would look for a different surgeon and discuss a 360 wrap. Since you still had reflux with the other degree wraps.

Take care,
Bill
Posted 8/2/2013 8:12 PM (GMT 0)
Hi

No, no swallowing issues! I think doing a 180 was a decision he made when saw my anatomy during the operation. As I say however even in the few weeks post op when it was so tight I couldn't swallow I still had severe reflux which is just bizarre!
Posted 8/2/2013 8:25 PM (GMT 0)
Im being told I don't have acid reflux and that its the esophagus not emptying properly.So food and liquids reflux in the esophagus which has apparently the same sensations. Maybe that's whats happening to you aswell. All I can tell you is it feels exactly the same as before the nissen. Barry
Posted 8/3/2013 2:42 PM (GMT 0)
Does anyone find BBQ sauce sets their reflux off something rotten? Recently had some and I think it's made things much worse!
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