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180 degree FP: Need a 2nd opinion, suggested surgeons NHS please.

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Posted 5/14/2015 2:17 PM (GMT 0)
Hi All,

I have poor motility and a surgeon I am under has suggested a 180 degree fundo (watson procedure), this is their preference with partial wraps. I was expecting to be lined up for a Toupet fundoplication, and so I was surprised that a 180 was suggested. From research papers this (270) seems to be more effective than the 180 at longer term reflux control. I am 25 and so am hoping for a longer term control. After a second opinion particularity from an excellent surgeon whom has experience with the 270 degree fundoplication. Any of you guys got any names you can msg me so I can seek a referral. The consultant I have seen is great and I do trust their judgement but I also can not ignore research data I am coming across.

Please reply if you can help guys,

Jim.
Posted 5/14/2015 8:23 PM (GMT 0)
Hi!
Depends where in the UK you are. I had a choice of 2 surgeons, but I was happy enough with my first consultation. You don't want to have this surgery a long way from your home! You can access information on the NHS website - then use choose & book to get a second opinion. I am 9 weeks post-op and happy I went ahead with it. There is a down side to the NHS trust area where I am - they don't do post-op follow up - so I wouldn't recommend for that reason, Go for the bigger university hospitals!
Posted 5/14/2015 10:06 PM (GMT 0)
Hi thanks sweetie.

Did you have a 270 degree wrap then? Whom and where did your surgery?

I am from manchester but seeing someone in London.

P.m me if you prefer.

Jim
Posted 5/15/2015 6:16 PM (GMT 0)
Hi Jimmy,
Not aware I can do a PM in this forum! I have had a 270 toupet done and it has been successful. The whole process was very slow though, and there's no aftercare unless you have problems. As you are based in Manchester, you could look into Mr S M Griffin at the RVI Newcastle, it's a bit of a trek for you - but he is supposed to be extremely good. If things hadn't have gone so well for me I would have seen him. It also depends on your GP - and if they use catchment areas or not.
Posted 5/15/2015 7:26 PM (GMT 0)
The effectiveness of the wrap isn't the issue here, it's your motility. Assuming you've had the manometry tests your surgeon will have suggested the appropriate wrap style for you. If your wrap is too tight then you will not be able to swallow, which is obviously something you want to avoid! I can see why you'd want a second opinion, undergoing all this for it to not work would be beyond a nightmare, but if your guy is experienced enough then he'll have suggested the Watson because your motility wouldn't handle a Toupet or tighter.

My surgeon was Chris Sutton here at the Leicester Royal Infirmary, quite a large university hospital. I'm the same age as you, had my wrap on the 3rd of Feb this year and I'm fully recovered! Maybe you can get hold of your manometry results and get them to a different surgeon and see if they would recommend a Toupet?

Posted 5/18/2015 8:31 AM (GMT 0)
Hi and thanks for the replies.

Sweetie UK

I am based in Manchester, but happy to travel throughout the UK. I will also look into Mr Griffin. Thank you. I will work with my GP.

JB The Great.

I believe the surgeon I am seeing performs a modified watson at 180 degrees, anterior as their partial fondoplication of choice. That is why I want a 2nd opinion, JB the great I will look into Mr sutton for just that, so thank you.

They (the surgeon I have seen) was more concerned at lots of burping on my tests (but I was intentionally burping as the blinkin technician nurse told me to "force the symptons" to show how bad it can get) than my swallowing, though I do have very weak peristalsis, but in contrast I also had very good oesophageal reserve (From the multiple rapid swallow test).

In allot of studies I have found the 270 wrap appears to prevent reflux and have better long term outcomes than a 180 anterior wrap, so I am just looking to see if this is an option for me, and clarification importantly of whether it is the right option for me. I trust the surgeon I am seeing, but as mentioned I think the 180 is their go to choice for partial fundo-op. This is a BIG life decision, so I want to make sure I have looked at a number of appropriate options.

I look forwards to either procedure and will be positive to it and the recovery cycle.

Jim.

Post Edited (JimmyR12) : 5/18/2015 2:39:43 AM (GMT-6)

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