HealingWell
Search Close Search
☰

A new idea for Hiatal hernia with severe gerd repair WITHOUT fundo, welcome to discuss

Support Forums
>
GERD & Acid Reflux
✚ New Topic ✚ Reply
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 9/8/2015 11:39 PM (GMT 0)
Hi here I have an idea for Hiatal hernia repair without fundo.

If a patient with 4-5cm hiatal hernia and completely dysfunctional LES, if we just fixed hiatal hernia laparoscopically, then implant endostim or LINX, most likely, the acid reflux control is not enough and the hiatal Hernia is easy to recur. If we fixed hiatal hernia laparoscopically, then perform TIF(since TIF can not fix big hiatal hernia), then implant endostim(Since endostim can be implanted on top of TIF, there is still enough space left for endostim), then the reflux control should be enough.

I know some doctors in Europe will fix Hiatal hernia laparoscopically, then perform Micro-Fundoplication (45°), then implant endostim. I think TIF should be better than Micro-Fundoplication (45°) since it had better acid control and it is less damage and reversible. It looks after Endostim is approved by FDA, we can avoid NISSEN by TIF plus Endostim for extremely severe gerd. Welcome to discuss.

Thanks,
Lisa

Post Edited (bye-gerd) : 9/30/2015 2:46:18 PM (GMT-6)

Posted 9/9/2015 5:59 PM (GMT 0)
Does anyone know when Endostim will approved in the U.S.? I have had both the NDO TIF and the Esophyx TIF procedures done and still have strong GERD
Posted 9/9/2015 8:19 PM (GMT 0)
It may need long time. I have tif at 2011, still have reflux. I am thinking about going Germany to get endostim implanted. Even LINX or endostim alone, there still have 10% need PPI. Tif plus endostim should fix any severe gerd, I hope.
Posted 9/10/2015 7:30 AM (GMT 0)
I'm not sure many surgeons would be willing to do all that rather than the standard NF given it has such a high success rate.
Posted 9/13/2015 2:52 AM (GMT 0)
I do not think doctors have any issue about it as long as you pay the money.
Actually I think this idea is much easier to be implemented than NISSEN, much less damage and can be reversible. I do not think the NISSEN SUCCESS rate is high. It is too difficult to create a wrap to be just tight enough to fix gerd, and no swallow, burping problem, even it is perfect after surgery, the vomitting can disrupt it, the frequently swallowing can dillute the artificial wrap. I remember some center report after 10 years, more than 40 % back to PPI, then how about 20 years? If Nissen failed, it will be very hard to fix. It just does not make sense to fix the problem still using 1950's technology. As for the idea, I think the insurance is a problem, and endostim is still not approved by FDA.
Posted 9/14/2015 1:44 PM (GMT 0)
Bye do you have a hiatal hernia? Did you have it repaired yet? I just had a paraesophageal hernia repaired and have been able to wean off my PPI meds so I believe I am having less reflux. My surgeon did say I would now be eligible for linx, tif or other procedures if I decided to go that way as long as my hernia does not come back.

I will say I agree that the Nissen success rate is not high as surgeons want you to believe only because of the side effects and reoccurance rate etc. One of the top rated surgeons I saw said as high as a 40% rate of reoccurance. I don't consider that successful. It really bothers me that a surgery that is being done so often does not have better research, published numbers and patient info, studies etc out there for all to see. It also bothers me that even within the gastro community there is still widely different opinions on the approach to do these surgeries. That of course is just my opinion. I still understand why people are doing the surgery. I know a lot of folks on here are very happy with their Nissen and I'm so happy for them and am glad people have that option. I really really did not want that procedure but I'm unique from a lot of people here that my reflux has always been well controlled with PPI's and taking them doesn't bother me.

I'd be interested to know when/if that endostim is available here.

I am happy that GERD is getting so much international attention and so many alternatives are becoming available. Gerd sucks!!!
Posted 9/16/2015 6:55 AM (GMT 0)
Michiganmom,
My hernia is small, about 0.5 cm. my LES is very loose. I remember some patient in this forum said his doc repair his big hernia first(very big), then perform TIF. So, I think maybe TIF has similar function as NISSEN for hernia, which is prevent the stomach going up again. The advantage of TIF is it is much safer, reversible. Compare with Nissen or partial fundo, it is a snack. After consulting with several doctors, they all think endostim can be implanted on top of TIF, there always enough space there. I am so exciting to know it. Then I figure out this approach to avoid Nissen and partial fundo for severe gerd or big hernia.
Posted 9/30/2015 8:42 PM (GMT 0)
I consulted a doctor in Germany and I was accepted for endostim implanted on top of TIF to completely fix my gerd. He said the success rate should be high. The total cost is 15000 euro dollar, around 17000 USA dollar. I need to fly to Germany twice or stay there for one month.
Posted 10/7/2015 8:58 PM (GMT 0)
Hey guys,
Just wondering if anyone has had a TIF takedown, undone, reversed. Had my TIF for 4 months now and have been regreting it since. Symptoms much worse. Yes my wrap came undone. Looks like a dome or hernia inside my stomach and not through my diaphragm. ppi's,carafate,antacids not helping.
Posted 10/8/2015 5:47 AM (GMT 0)
If the patient's gerd is not severe, the LES still has some function, TIF should can fix it. If the suture is loose and TIF is partially undone, the doctor can fix it. I read an article reported this case, after the TIF is fixed, the gerd is gone. Always find a good doctor for any procedure, this kind of mistake can be reduced to minimum at good hand.

Yes, TIF can be reversed laparoscopically, my doctor said he reversed 3 cases, 2 of them are very easy, no scar tissue. 1 patient has some scar tissue, harder to be reversed, still reversed successfully. If something wrong with Nissen, it will be much harder to fix.

Lifting can trigger Hiatus Hernia, I remember one patient with big Hiatus Hernia reported his doctor fixed his Hiatus Hernia first, then perform TIF, his gerd was gone. Then he did a lot of heavy lift in the gym , the Hiatus Hernia come back. His doctor reversed his TIF, fix the Hiatus Hernia again, then implement TIF again. His gerd was fixed again. I think his LES is still functional, so TIFF in this case is sufficient.

If TIF can be fixed, it will be easier than reversed.
✚ New Topic ✚ Reply