hiatal hernia repair without the wrap?

Hi Brian,

I'm getting surgery done in 8 days here in Orlando Florida. My surgeon is Dr. Farid Gharagozloo. He does a new revolutionary procedure that is 'minimally invasive' via a robot. The surgery is called a Gastroesophageal Valvuloplasty and what they do is recreate the normal stomach valve how it is supposed to be at birth. they then put sutures to keep it in place that dissolve and do not get removed. It's a permanent solution (so far 100% success rate) but I'm still really nervous to have it done.

Here is a link to their page.
https://www.floridahospital.com/celebration-health/thoracic-surgery-program/specialty-treatments/digestive-health-gerd

Cheers,

Wes

Hi Wes, I advise you to run -- not walk-- to Dr Inayat(GI). Dr. Gee can't help you unless you have another EDG. I'm seeing Dr. Gee on Thursday, and I'll post an update after I see him.

I was on a FB site and I found so many people with so many problems that they are having their Nissen wrap procedures taken down. I wish I could help them. I have been referring the failed Nissen's to Dr. Gee because when I went for my preop appt, there was a woman who previously had a Nissen and she couldn't swallow. Dr. Gee performed a esophageal valvuloplasty on her, through an incision in her back, and she was very content with her status. I'm sure that here are plenty of Nissen's who are doing well, but if it goes bad, there are all kinds of problems. Many people have had the wrap performed several times, and by this time, they have a small stomach. Many can only eat small meals, no caffeine, French fries (nothing fried) or steak, can't burp or pass gass and they are bloated. I admit I don't eat much of that stuff because I have to keep my weight down, but if I want to, I can.

Okay back to me. Postoperatively I don't recall ever feeling great. I always had chest pain (not from my heart), and a gnawing pain that kinda felt like heartburn. I would have it for several days, then it would go away. I thought it wouldn't come back, but I started realizing that not only did it come back, but worse. My husband suggested that I get checked out.

I have level D gastritis and esophagitis, a stricture. Not sure why I have all that inflammation, but I have to assume it has been there all along after surgery. I'll be sure to ask Dr.Gee. I'm back on PPI and Carafate, and I feel good. I have an appt with Dr. Gee on Thursday and I'll post an update afterwards.

I wish you well. Look for my update on Friday.

Post Edited (Yellow1955) : 9/8/2017 9:06:21 AM (GMT-6)

It is interesting that your were told that the esophagitis was a part of the healing process. All of my pain is from the esophagitis and gastritis, and Carafate suspension took my pain away.

I felt better the first three months, then it got worse 3-6 months. . I get no heartburn from it like before, all of what I get (according to Dr Inayat) is acid reflux. I was encouraged to go off all PPI in the 3-6 month period, but I don't believe the PPI medicine made a difference. I had an appt with my primary care doctor, who told me to go back on the medicine. So I made an appointment with Dr. Inayat right away. I got a quicker appointment in the Winter Garden office. I had to wait to see Dr. Gee's Nurse Praticioner for 3 weeks. Dr. Gee only sees new patients.

You mentioned caffeine and alcohol. I gave up coffee, and didn't eat crap, but it didn't help the pain. I would get the pain about one hour after eating.

I looked at the website and since I had my surgery in December, there is a whole robotic suite of surgeons. I'm impressed. I'm trying to figure out why Celebration is the only place that has robotic surgery.

I wonder what happened to IrishBrian? He had a large hernia. If he didn't have surgery I suggest he get evaluated. My hernia was 4 cm and my stomach went through the hernia and was upside down in my chest.

Talk to you on Thursday or Friday.

Post Edited (Yellow1955) : 9/8/2017 9:09:02 AM (GMT-6)

I just joined this forum. My GERD complication is pulmonary fibrosis, which we know for sure has been caused by chronic aspirations of digestive fluids into the lungs for many years. Since May of this year, I live and breathe with help from an external oxygen concentrator.

I had the robotic valvuloplasty for hiatal hernia in Celebration Hospital on Friday morning 7/28/17 from Dr. G but right away he could see the contents of my left chest cavity included liver, spleen, stomach and colon (really!), so he closed up and scheduled my second, larger, thoracotomy for Monday morning.

I am not exaggerating to say that in my opinion Dr. G is a brilliant and an annointed servant of our Creator and I am sure Jesus and my angels were by his side through those 2 surgeries, the second which appears to have been a complete success at this point 26 days later. I just read the surgical notes and my mind is completely blown to know all the delicate work that had to happen to carefully move every organ back to where it belonged, construct the valve, construct the missing diaphragm, restore the lung that was completely squashed, put the opened rib back together, and on an d on. And everything is now working! Glory to God!

I just want to give some tips for living with your reconstructed valve which I am just loving - start making organic soups in a super blender. I have a Vitamix that I just can't say enough good things about. I have been eating delicious homemade organic soups every day and I am never hungry and never tempted to eat a huge amount of food or fried food or the rest of that food that you KNOW you must avoid. I had my daughter staying with me for the first 8 days at home and she made all the soups and stocked my freezer but I then hired my dog walker to work 3 hours in the morning doing all the things around the house that I can't manage yet and make more soups. Really, some of these soups require a bit of chopping and maybe 15 minutes of stove top cooking before you blend but a few require no prep at all - just drop the ingredients in and blend! One of very easiest soups is tortilla soup - just google Vitamix tortilla soup recipe.

I am on the pepcid prescription called "Famotidine" and I understand that this is necessary so that my esophagus can heal without irritation. I am assuming that I may have to stay on it long term, which is fine with me. My 2 post op visits in Doctor G's office have gone extremely well with Amendha and Barbara commenting on how well my incisions are healing. The removal of the stitches and staples from 2 surgeries was intense, no doubt about that!(!) but I made it through.

I am not at all worried about digestive issues since I have been suffering typical gas, burps, heartburn, diarreah, vomiting, etc for so long that it never felt life threatening to me. All those symptoms are gone right now When you can't do much without getting dizzy and short of breath, that's the thing you get get concerned about!

But my long term prognosis is excellent. Dr. G. told me he is sure that I will be losing my "little friend" the portable oxygen concentrator that I have to take with me whenever I leave home - he said "take it to the bank" - it is going to happen. Dr. G. is right !

Post Edited (GratefulAlways) : 9/4/2017 4:30:19 PM (GMT-6)

Hi Yellow (1955 is my birth year). Thanks for saying hi.
Barbara in Dr. G's office did say I can eat the food I want now but I want to just keep it simple so I'm still mostly on soups and smoothies and I have a half sandwich of ham and cheese on soft bread when it appeals to me. I like the Dole grapefruit cups and to throw peeled organic apples in the blender for healthy apple sauce. I am getting my protein from supplement powders in the smoothies. I was told to expect some heartburn/gas/swallowing pain in the next few months and I do expect it is starting but I am careful to keep taking the prescriptions on time.

I have been hesitant to stand under the shower all this time because I have to go off the oxygen and the fear of water pressure on all these incisions that need to heal but that's my next challenge to start. One day at a time but life is good and I expect each day to get closer to healthy

Hi Charlie, this isn't about the Nissen wrap, it is another procedure - a robotic assisted gastroesophageal valvuloplasty. I agree there are lots of bad symptoms with the Nissen wrap. The surgeon puts the esophagus back into the stomach (where it belongs) creating a valve between the stomach and esophagus (something we all had until we the hiatal hernia (HH), which pushed the stomach through the HH). The HH is closed using a Vicryl mesh which dissolves during the postoperative period.

I've found several people who had the procedure, we are all doing well, except for some postoperative inflammation. Dr Gee told me that he has done 500 procedures since he has been in Florida. I had my surgery in November when he was fairly new to the area. There is plenty of information online. He has been in Washington and Arizona. He is very well qualified and has had excellent training. He takes the time to explain the procedure and ensures you understand. I trust him. I feel better than I have in years. I have no more heartburn, and the regurgitation is all gone.

I had a gigantic hernia and my stomach was through the hernia, and upside down in my chest. I had lots of symptoms.

His name is Farid Gharagozloo, and here is the link. He is located in Celebration, Florida. Let us know if you have any questions.
https://www.globalroboticsinstitute.com/robotic-treatments/thoracic-surgery

Post Edited (Yellow19) : 5/2/2019 10:38:25 AM (GMT-6)

Thank you for posting during your valvuloplasty (by Dr. Gee) postoperative period It is good for others to see how well are doing. There will be another individual (that I found) posting her update on this site also, but it has been so long since we had the surgery, we forgot how well we did.

No Charlie, I didn't have return of the hernia. I thought that I did. I had level D out of A-D esophagitis and gastritis. However, I wasn't able to see the surgeon for a month after I went for a repeat EDG. The manometry showed reflux but it was from my esophagus being so swollen, that my newly created valve (between the esophagus and stomach) wasn't working correctly yet. I'm doing fine now. I rewrote the stuff because it is so confusing. However, I am trying to stay calm because I live in Florida and I am worried about the monster hurricane coming at us.

It is common go get inflammation during the postoperative period, but my condition was exacerbated because my brother was diagnosed with lung cancer and finally succumbed during my postoperative period. I was upset over everything at that time.

Post Edited (Yellow19) : 5/2/2019 10:40:08 AM (GMT-6)

This is now week 8 in my recovery and for 3 days I am experiencing nausea and vomiting about an hour after eating a small bowl of soup and drinking 12 ounces of tea. I did add in some chocolate pudding when this started so I will stop that and I guess need to only drink water. :-(
I think this is all to be expected during the 6 months of recovery so I am telling myself all is still well, but feeling seasick on dry land again today. Dr. G released me with no more checkups. I only have a pulmonologist and primary care doctor now and neither are getting too involved in surgical recovery details. I will try to contact Dr. G's nurse practitioner if this goes on a while. I am only on the pepcid now. Maybe there is another medication to help with this.

Hey there - so glad to hear you are feeling great. The nausea I was feeling has stopped - I think it's related to the volume of food plus liquid being just too much at once. It's helpful to know how recovery is progressing for others. I will update again in time. I really appreciate your reply!

Any updates on how you are doing today Fitboy? I'm considering this procedure. I have uncontrolled GERD and am on 40 mg Nexium and 300 mg ranitidine daily. I am normal BMI 37 year old female.