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What factors affect Nissen sucess rate?

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GERD & Acid Reflux
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Posted 10/16/2014 8:03 PM (GMT 0)
Hi again.

I've been dealing with servere hearthburn all my life, and recently I've gotten problems with my throat as well. Yesterday I got the results back from my second round of tests. My surgeon told me I'm a candidate for the Nissen and she thinks I should go for it. However she warned me several times about the complications that might occur. Now I'm trying to find out what the factors that affect the sucess rate of the surgery are. For example my surgeon confirmed that there's a higher sucess rate for people who get relief from ppis. I've also read that people with hiatal hernias and a higher reflux score have a higher sucess rate. Obviously the skills of the surgeon are also crucial for the outcome.

Do you know of any other factors that are important here?
Posted 10/17/2014 2:33 AM (GMT 0)
As far as i know, the doctors experience and past success rates is very important.

There are some vital tests you need to do. The manometry will be important, because it will show if your lower esophageal sphincter is closing opening and closing properly when you swallow. If it isnt the surgery has a good chance to help you. Also the 24 hr impedance and acid test will try to correlate your symptoms to reflux events in your esophagus. If there is correlation, then again you will have a good chance of success. You should get a surgeon that does these tests before hand.
Posted 10/17/2014 5:14 AM (GMT 0)
Following the guidelines set out by your surgeon but also by the people here who tend to know more than the surgeons. There is a wide variance in surgeon guidelines. More conservative works better such as following a liquid diet post surgery, moving to soft foods, etc. some surgeons jump fast into soft foods and so on. Weight lifting restrictions post surgery. Keeping your weight at a healthy range and avoiding gaining too much weight r gaining too fast. Avoiding trigger foods and those foods recommended not to consume as they cause gas and bloating and therefore adding pressure to your wrap. Avoiding vomiting at all costs. Keep nausea meds with you always. That's what pops into my mind right now. I'm sure I'm missing some. Having the proper tests prior to surgery. Finding a great experienced surgeon. Hope these help.

Debra
Posted 10/17/2014 10:13 AM (GMT 0)
Wrap_down_uncle: I've done 2 manometries but I only got the notes from the first one. Says that i got a relaxing les and no signs of achalasia. My first 24 hour ph measuring gave me a Deemester of 40. I also have a hiatal hernia. I'm feeling hopeful the surgery could help me.

Wendy workout: I agree and that's why I'm asking for advice here. I've completely lost faith in doctors that doesn't give a flying F about you, and a medical system that just push you around between different "speciallists". When it comes to this condition, the only research and suggestions that has made me feel better are my own. One of the few things I can't do my self is the Nissen and that's why I want to be 100% sure it's the right decision by seeking advice from you guys.

Thank you for the help, none of the things you mentioned have been brought up by my surgeon. I'l make sure I get some anti nausea meds if I go through with it.
Posted 10/17/2014 1:20 PM (GMT 0)
I'd emphasise the point made earlier, the quality of the surgeon. Their experience, success rate, everything. And make sure the person you meet is the person performing the operation, you don't want to be a training exercise for a student.

Remember, this isn't a simple remove / reduce operation where the surgeon follows set steps - there is a lot of judgement involved. Wrap, size of wrap, tightness, the lot. And if the surgeon gets it wrong through inexperience it is you who is paying the price.
Posted 10/18/2014 4:42 AM (GMT 0)
Yes age warn, my surgeon did not mention all of the above that I posted. Over time and having some complications, more came out. As patients we are not well informed and educated going into this surgery. Doing your own research is the key as it sounds like you are doing. I think of this surgery similar to giving birth actually. No matter what the doctors say, it's a very unique experience and hard to describe in words at times. You have to experience it to know. Hence why I think most doctors don't truly get it. I too do not trust the medical system. When you find someone you trust, you stick with them. Hopefully you get all the info you need and go into this confident and prepared. Makes it easier. It's been a tough recovery for me but definitely worth it. I'd do it all again.
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