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Need Paraesophageal Hernia Surgery...what type of surgeon

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Posted 4/10/2016 5:28 PM (GMT 0)
Hi, I"m new here. I need to have a large hiatal hernia fixed. Little history, I"m a 10 year post gastric bypass patient that has part of my gastric pouch and original stomach through my diaphragm. Went to my bariatric surgeon who said will do the surgery but it will be riskier than my bypass. He's also a general surgeon.

I get the feeling he's not too confident in doing it and I have been desperately researching this. I keep running into thoracic surgeons.

Is there a type of surgeon given my new anatomy that should do this surgery? My surgery date is May 16 and he plans to do it robotically.

Thanks

Brenda
Posted 4/10/2016 5:53 PM (GMT 0)
choose carefully, you want a surgeon, who has done this procedure before. one who is confident, and competent in his/her, ability to perform this procedure. and as important, a surgeon you feel good about. this surgery is a big deal. the surgeon defiantly makes a difference. good luck
Posted 4/10/2016 5:56 PM (GMT 0)
Thank you...I'm fortunate enough to live near Boston and my surgeon is in Boston, but there are also other hospitals in Boston that mention specifically about doing this surgery. I think I'll call tomorrow to try to fit in a consult
Posted 4/11/2016 12:14 AM (GMT 0)
I would look for a thoracic surgeon. They concentrate on the chest cavity organs and usually have expertise on the various surgeries of the the esophagus.
Posted 4/11/2016 1:51 AM (GMT 0)
Thanks I'm going to call one for a consult tomorrow
Posted 4/12/2016 12:35 AM (GMT 0)
Normally I would say thoracic surgeon, but this case is different. One thing to ask - how large is the hernia and how much stomach and anything else is in the chest?

Depending on those answers, the bariatric surgeon who did the bypass may be competent for this. He doesn't have to do a Nissen wrap, just close the hernia. This guy already knows what he did before.

There are a lot of new general surgeons who have studied laparoscopic surgery in the last several years. A bunch of them have a lot of experience in this area now. Ask your surgeon about his experience.
Posted 4/12/2016 11:48 AM (GMT 0)
Hi Alice, you are absolutely right. And yes, there is nothing to wrap.

My gastro suggested I follow back up with my original surgeon, most other surgeons suggested the same. My gastro surgeon has repaired a hernia along side a bypass surgery if he sees one. 12 years ago, I didn't have a hernia when he did mine. I think what threw me was the type I have, I spoke with his nurse yesterday (I missed his call), and she assured me he's repaired these before.

I guess if I put myself in his hands once for a major surgery, I have to have faith in him again. As many of you know it's just scary because they have to tell you all the negatives (which they did in the first surgery too).

As of right now we know a portion of my bypass stomach and my "remnant" stomach is through the hernia and the hernia is large. He will pull everything through and close the hernia and only use mesh if he feels it needs it.

April 25th is the date set...I have plenty of anxiety medication until then :) And to keep a soft diet.

Thank you all for your input...it has really helped me keep things in check and perspective. I was going nuts because I couldn't find someone with the same situation, without the wrap, recovery time, etc. Guess I'll be posting updates for the next "me" that may come across this forum. I'm so glad I found it :)
Posted 4/12/2016 11:57 AM (GMT 0)
I'm glad the surgeon will try to avoid mesh. It's been known to erode through the esophagus. My surgeons (they operate as a team) tole me about that problem and said thy only use Ed my own tissues for the repair.

One thing to ask th surgeon about is whether your esophagus is long enough, and does it need to be "let down" to stay below the diaphragm. My esophagus had to be cut loose from its attachments, but fortunately didn't need to have part of the stomach made into an extension. You don't have enough stomach left for that procedure.
Posted 4/12/2016 12:06 PM (GMT 0)
Good question! I will certainly send him an email and ask him. Thanks!
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