Nissen Fundoplication Redo???

I had a Lap Nissen Fundoplication about two years ago and after the initial post op diet, have been reflux free until a couple of months ago.

The acid reflux has been getting steadily worse until last week when it woke me up in the night and made me violently sick and start bleeding internally.  This was made worse as I am also on warfarin to help prevent blood clots in my legs.

To cut a long story short, I had a endoscopy and as well as confirming the bleeding had stopped, they also advised that the wrap looks to have come unravelled on one side.  Looking at the photos they took from inside my stomach, one side of the entrance was all nicely folded in a consertina style, but the other side only showed two slight folds.

I off to see the consultant tonight to discuss what has happened, but it looks like I may need the fundoplication redoing/repairing.

Can anyone confirm if this is unravelling is common, and is the recovery from a redo op the same as having the full procedure done from scratch?

Since the vomiting blood episode last week, I have been put on Lanzoprazole, but I am still getting some acid reflux at night, so something needs to be done.

Cheers

Andy

He is also going to give me some different tablets to the Lanzoprazole I've been taking.  Can't remember their name of them, but I'm not holding out on them working.

When I had my first op I did research the Consultant/surgeon, and the one I am seeing is suppose to be one of the best in the UK.  So no worries there!!

Hopefully should know some more next week once I have had all the tests done.

I need a redo and am based in the UK too.  Are you happy with your surgeon and is he based in London?

Thanks

Simon

Welcome to the Healing Well Wrapped Club! You didn't say how long ago you had your vomiting episode.  If it was within the last few weeks, I wouldn't panic yet. 

After a vomiting episode, your wrap has been traumatized and will be sore for quite some time.  I suggest you baby it with soft foods until it starts to feel better.  Even after you've had your surgery for some time, a vomiting episode can be very painful to your wrap and hernia repair.  That doesn't mean, however, that your wrap and hernia repair have been destroyed.  Rather, they've been injured and will need some time to heal.

I had my surgery in 2009, and have had 3 vomiting viruses since then.  I vomited once each time (although my surgeon said I wouldn't be able to, once the force was strong enough, the vomiting effort was successful).  Each time, I only allowed my self to vomit the one time and used Compazine suppositories to stop any further vomiting or retching.

Like you, my wrap gave me trouble for some time post-vomiting.  Using the acid suppressor is a good idea, as it can protect your stomach and wrap.  Have you ever tried Carafate suspension?  It coats the wrap and stomach and helps protect it so it heals more quickly.  I suspect you'd find some relief if you used it.  It requires a good prescription plan, as it's pretty expensive, but I recommend you ask your doctor for a script.

Hang in there.  I expect with time and patience, and a little babying, your wrap will get feeling better again. 

Take care,

Denise

Oh, yes.  In my situation, my GI doc threw meds at me even though my lungs were horribly compromised because of reflux.  Even when he finally decided to give me the name of a surgeon, it was only with the "or continue taking meds" option. 

Many surgeons aren't qualified for redo surgeries, as it is, indeed, more complex and requires someone who has done many.  Unfortunately, you'll have to do some research and find surgeon(s) who are capable redo artists.  Even your original fundo required an artist, as this surgery isn't like taking out a gallbladder or appendix.  It's very specialized operation, and requires someone who had had lots and lots of experience. 

Your best bet is to find a university or medical center that deals with lots of these redo surgeries.  Bill, a moderator here on the forum, has two redos, and is doing extremely well.  It's hunting season for him, so he's not around the forum as much his time of year, but I'll shoot him an email and alert him about your question.  He had some additional and very unusual challenges with his recovery, and even with that, he is doing extremely well.  Here's his recovery journal:

https://www.healingwell.com/community/default.aspx?f=45&m=2337138

Glad you've found us.

Best wishes!

Denise

It's been a long time since I last posted.

I've been struggling on over the past few years with the various anti reflux medication and been getting steadily worse to the point where I have been hospitalised twice in 3 month with my asthma being flared up by the acid reflux.  I have also beem waking up constantly on a night time and have become very run down.

My original consultant did another barage of test again and did agree with me that I had reflux, but the wrap was showing to be normal on the barium swallow and endoscopy tests.  The 24hr ph and monometry test came back showing the wrap wasn't working and letting acid through frequently.  The pressure of the muscle was around 7-8mm/Hg and the demeester score was 61.  I don't fully know what these mean, but I was told they abnormal for someone who has had a fundoplication.

My consultant then told me that he didn't feel there was anything further he could do for me, but eventually referred me to another more experienced consultant who has now agreed that a redo is needed.  I am booked in for this Friday and can say I'm not looking forward to going through all the post op recovery again.  Saying that, I am looking forward to sleeping properly again and getting my chest back in order.  I just hope it isn't any worse that the first time round as it took me quite a while to recover properly.