Esophageal Valvuloplasty instead of Nissen for GERD/Hiatal Hernia/Heartburn

Hi everyone,

I have been suffering from GERD/Hiatal Hernia now for about 10 years. I'm a 25 year old male and after being on PPI acid reducing medication for 10 years, I have finally found a surgeon that is going to fix my hernia. My symptoms include terrible acid reflux, sleep apnea, asthma, and I think my hoarseness. It's beginning to become unbearable and getting in the way of my everyday life. It's hard to fake not being in pain so I decided to find a permanent solution.

The main surgeries that have been around to fix GERD and acid reflux has been the Nissen and Toupet Fundoplication, but apparently there is a new revolutionary procedure that my surgeon performs, that has no ill side effects like the Nissen. The procedure is going to be done robotically (via the Da Vinci system), and will only need 5 small incisions (4 mm each). The Surgeon then will go in and recreate the stomach valve by putting the end of the esophagus into the stomach about 2 cm and suturing it to keep it in place. He will use sutures to keep everything in place and repair the hernia with no surgical mesh or stitching. The sutures are made of a simple sugar that supposedly bonds the cell's tissues together.

My question is: Has anyone had a Valvuloplasty procedure before or knows of anyone who has? It's hard comparing people's Nissen results to that of the valvuloplasty since they are completely different procedures; however, there is almost no literature whatsoever online concerning the Valvuloplasty.

My surgeon has mentioned that he has a 100% (yep i said it) success rate, and has had no recurrence of hernia or heartburn. I have about 8 days until my surgery and regardless of his success rate, I'm extremely nervous. I have been on Xanax periodically to help with this - but the sooner it comes the more worried I get.

I will keep you all posted on my recovery.

Thanks!
Wes

Post Edited (Flboy32801) : 1/24/2017 4:10:18 PM (GMT-7)

Hi Alcie,

Thanks for your post

The incisions are pretty similar except the way my surgeon does them is create a 4mm slit in the skin in each spot and the robotic arms expand up to 1 CM to fit the instruments. so they don't even put stitches in your skin, the skin closes on it's own with a special glue they created at Florida Hospital.

As for the sutures, my surgeon has a patent on the material they use, I guess it's made of a sugar like material that dissolves; therefore, bonding the tissues together permanently. It seems very advanced but I haven't seen alot of online articles.

I didn't get a second opinion because I went to a few doctor's prior that were terrible. I searched and found him online since he has a really good reputation and is leading provider of this newer procedure.

-Wes

By stitching I meant internal stitching. My NF stitches were just steri-strips. I don't want glue because of allergies. My scars have disappeared completely. I wonder how dissolvable sutures can hold the esophagus in place long enough for it to stay there. I would like to read more on that because my hernia and the wrap sutures are permanent.

Pat gave you some very good advice. My surgeon had done thousands of NF and varieties over many years when mine was done. The success rate was in the high 90 percent range. He works with a team, not solo. My surgery took about 4 1/2 hours because there was a large hiatal hernia.

Best wishes!

Wes, your procedure is new to me and I know you look forward to being well again. Please write frequently with their pre and post surgery instructions to you. Tell us all about it.

The hospital confirmed the number of procedures , but were they all 300 of this specific procedure in ONE year or did it include routine wraps (fundo) in that figure. Did the doctor tell you? How many will be in that 16 year study--you can look up this study as they have to be approved. The Sages study looks favorable--I'm sure you saw it. Were you able to talk with a patient that had the procedure you're planning on-- they should be able to work it out for you--it was very helpful to us and put our mind at ease.

Thanks for the explanation on the sutures, they sound like biological sutures . It's comforting to know that they have never come undone. We will follow you on your journey to feeling better. Let the body heal at its own pace and don't be in a hurry for a workout. Please keep writing. Wish you the very best and you WILL get better.

I've had several surgeries on various body parts and had several experiences with dissolvable sutures. In some of my surgeries, on a leg and abdomen, I've had bits of sutures pop back up through incisions within days to weeks. I don't know what they were made of, but some were thick and white and some were thin and purple.

Whether dissolvable sutures make a scar I don't know. My non-dissolvable sutures are holding my diaphragm and parts of my abdominal wall together. I have a couple of pieces of mesh in my abdomen, but it's not used near the esophagus because it can cut it.

Many dissolvable sutures are supposed to dissolve within a couple of weeks, but some types last for months.

My main question would be whether dissolvable sutures would keep the hiatal hernia closed. The diaphragm is a strong muscle and there would be tension on any sutures there. Would scar tissue be strong enough to hold permanently?

The vavluloplasty is an interesting alternative to NF. It's not new, as I've read about it in the '80s, but has been updated since then. I hope it will be a better possibility for patients in the future.

Just google esophageal valvuloplasty There are dates right on the brief description of many of the studies.
/www.ncbi.nlm.nih.gov/pubmed/3752383
There are more!

But these old studies weren't done the exact same way they are doing the procedure now. The one above describes a flap, and that's not done anymore, I don't think.

I don't believe much of what I read on forums, but scientific studies are mostly informative.

Those are precisely the sutures I was concerned about. Have you found any other studies using absorbable material for such critical, stressed areas? This is very interesting!

Wes, have you had your surgery yet? On Sept. 27 I had the 270 degrees surgery also. The pain has been minimal. I still am not able to eat much, I eat several small meals a day. I would be interested to know how you are doing if you have had the surgery.

Yellow1955

Who are you replying to?

Flyboy, is there any way I can get your email? I would love to see where you are now with your recovery at this point (especially the "inflammation"). I'm nearing 3 months at this point. Hope you are doing well

Wow that is great that you had the procedure done. My stomach was up in my chest too. We were close to something bad happening. If the blood supply had been cut off to the stomach, It would have been very serious. After eight weeks, you will be fully recovered and able to left heavy objects. Dr Gee is the best.

Post Edited (Yellow1955) : 2/15/2018 6:57:18 PM (GMT-7)

Those whom have had this or know this answer: What is the cost (out of pocket) of Dr Gee doing this surgery?

Is Dr Gee and Dr. Farid Gharagozloo the same person, or two different surgeons?

Thanks

Post Edited (RRose) : 5/4/2018 1:26:42 PM (GMT-6)

Hello. I just joined this forum. I was a normal, healthy, VERY active (at the gym every day) person until January 2018. I contracted the flu and my life has been a nightmare ever since. Recovery from the flu took a good 2 weeks. However, even when fully recovered, I knew something wasn't right. My stomach or esophagus was very sore. I couldn't eat as much as I used to. Things got progressively worse to the point whereby I could hardly eat anything.

I had an endoscopy and the doctor found and opened a Schatski ring.He also found a hiatal hernia about 2 cm. Obviously I had reflux but the only time I felt it was if I slept on my right side. As this was easily avoidable, I didn't think much of this problem. After the endoscopy my reflux got progressively worse. It said on the endoscopy report "Possible Injury." Of course the doctor never told me this and I was unaware until I requested a copy of the report.

My reflux got progressively worse to the point where it's non-stop 24/7. The sphincter must be stuck in the open position. They diagnosed me with esophagitis. I was just wondering, please, if anyone knows if the esophagitis inflamation can include the sphincter and if there is any possibility that the sphincter can heal? The doctors give me no information in that regard.

I just stopped ppi meds and H2 blockers. I was on them for about 2 months and they made me so ill I couldn't function. I had neurological symptoms whereby my hands were numb (still are a little), spacey, eyes weren't focusing correctly also joint pain, muscle stiffness and much more. I'm now only on Carafate which is soothing and hopefully healing but doesn't seem to do anything for the reflux. Also use Gaviscon (from UK, ordered on Amazon).

I'm just wondering if anyone has ever had an esophageal sphincter heal and thereby resolve reflux. I realize this is probably wishful thinking. Thanks so much. I hope everyone enjoys this holiday. If anyone told me a year ago I would be in this position I wouldn't have believed them. I had never heard of reflux disease! My life is gone and I am an invalid. Does anyone ever get their life back? I am interested in Dr. Gee i Florida Hospital and his method. I want to go that route. I know there are posts on here about him. I hope people who have had his surgery will continue to provide updates.

Thank you, Yellow 1955, for your response and on a holiday no less! I hope you feel so well that you are enjoying a barbecue! I'm just wondering, please, if you are actually totally free of all reflux symptoms without drugs? Can you eat anything and everything you want? Is your life completely normal in that regard? I now have constant regurgitation since stopping the drugs. I'm hoping this will calm down but am so worried that this is my new norm.

I live in NY. I contacted Dr. Gee's office by email yesterday and am awaiting a response. I can't call because reflux has taken my voice from me. I only hope I can hold out until everything can be arranged. I definitely don't want the nissen. I'm concerned that it might be months before I can even get an appointment for a consult and then more months before surgery. I still can't believe this happened to me but I guess everyone feels this way.

This is a great forum. It's wonderful to know that I can come here for information, support and understanding. I will try to do the same for others.