Hiatal Hernia and TIF or Linx Surgery

NNCanada,

I can't answer your questions, but can only tell you of my experience. I was not suffering from reflux or heart burn but did have erosions in my stomach and esophagus. I also have asthma and severe anemia caused from the hernia. I was taking iron twice a day to get anemia in check. My hernia was about 10 cm and the surgeon gave me no choice. He said I had to have the nissen and right away. Your situation may be completely different. I hadn't even heard of the nissen until a month before surgery and like I said, the surgeon gave me no alternative.

Good luck to you!
Starry

I have had the TIF procedure. Unfortunately, with a hiatal hernia of 5cm, your only surgical option is a HH repair/Nissen, both done at the same time.

The problem with a HH larger than 2.5cm is that the surgical site won't stay "put" below the diaphragm. The TIF actually pulls the LES into the stomach slightly, and fastens it in place. With a larger aperture in the diaphragm as a result of a HH, the fundus would be prone to extending into the chest cavity, and perhaps even force a larger opening.

-Bruce

I had a TIF in April of '11. My surgeon said that he would first look at my hiatal hernia and if it was too large he would repair the HH and then do the TIF. My HH was not that large and he did not have to repair it first.

My surgeon said the same things, Bruce. If your HH is large the nissen is the way to go. Otherwise you risk having your stomach pulled up into your chest.

The nissen is not a bad surgery. I was scared to have it because I'd never had surgery before. I wanted the TIF or linx. My surgeon said he had stopped doing the TIF because there was so many complications going on with it at the time and the linx was still in trials.

After surgery I had five little cuts on my stomach. My stomach was tender naturally. I followed the diet carefully during recovery and limited my physical activities for six weeks. It's now been two years since my surgery and life is good. No more choking on acid and gunk. I can eat almost anything I want with no trouble.
I say go for the nissen.

Thanks everyone for your responses.

Kitt - My question is whether a surgery can be performed where a hh repair is performed for a large hh followed by either a TIF or Linx procedure (so just one surgery for both procedures).

From what I have read it looks to me that when you have a hh, the route to go is hh followed by Nissen. My personal preference would be to have a surgery with hh repair and then a Linx procedure (both done at the same time). I know the Linx procedure is not available in the U.S. yet but when it becomes availble it seems to have a few advantages over Nissen, one of them being the fewer risk of side affects and the fact that it can be reversed.

Thank you

Post Edited (NNCanada) : 1/2/2012 8:41:00 AM (GMT-7)

NNCanada,

I don't know the answer to your question but I will tell you what my surgeon said. Hernias tend to come back if just repaired. The nissen wrap helps to prevent that by reinforcing the area. I had a large paraesophageal hernia so that might make a difference.

Starry

Hello everyone!

I've been reading every post I can on here, and it is a wonderful forum. I had a TIF and a partial Nissen (it had a special name, this partial Nissen, but I can't recall what it was) on 12/23/11 and can relate to many of your experiences.

The diet is VERY hard, especially so during the holidays. I made a big mistake New Year's Eve and had a drink of alcohol, and paid for it with pain and what felt like a bad attack of reflux. That sleepless night was my own fault. I found that small amounts of food (1/2 cup) at a time, somewhat warm work the best. I can hardly wait for eggs -- i'm allergic to milk products and really want a protein source (allergic to soy, too). I can drink Coconut milk and the Silk brand is good, in case any of you out there have a similar problem.

Like Starry, I had big problems with absorption (iron and the B vitamins) despite aggressive therapy with vitamins; has anyone heard whether or not PPIs can interfere with vitamin absorption?

I have not much pain now, but I do have some increasing shoulder pain. It's good to know this will likely fade with time.

Anyway, I had a 4cm HH and low pressures in my LES; so, I had a partial Nissen wrap immediately (same time) followed by a TIF.

I also have other chronic conditions, including a blood clotting disorder, a thyroid disorder, degenerative disc problems and am bothered by constipation. Does anyone know if GERD and constipation go together???

Also, I am a runner, even though my conditions sometimes lay me up for a while. I'd be particularly interested in other wanna be or real athletes out there who try to remain active despite chronic conditions.

JB in Northern CA

Back to original question could the HH be repaired then the Linx performed?

I believe it can be. I would have the HH repaired and wait awhile to make sure it stays.
Then do the Linx. Do you have a surgeon?

Had my hiatal hernia repaired (less than 3m) and the Linx done on August 30th....its been almost 10 days and I'm not gonna lie to ya....its pain, pain and more pain....got the Percoset to take but dont wanna rely on it here after day 7....taking Tylenol to keep internal swelling and inflammation down as much as possible.

So glad I found this forum in not feeling like the only one with symptoms afterwards....

Each day is different....eating pretty much anything slowly, swallowing every 20-25 seconds is my only choice....
trying to drink water by itself is so painful....gotta take any meds with baby foods I enjoy or applesauce....gotta drink water immediately after eating something.....anyone else going thru this misery?

Today I made the mistake of eating some bread and omg, I almost screamed out loud with sharp pains in the right side of my back....felt like a knife being pushed in harder and harder....along with extreme pressure below my chestbone which I get often....

On the bright side I can bend over, walk around, do some gardening, sleeping better than before without having to urinate two to three times a night....Im up only once....prob cuz Im not taking in lots of liquids.....
able to drive the car since day after surgery but get fatigued easier, which will probably pass....

Im staying optimistic and hopefull all this will improve with time.....probably months here....

And my five incisions with the glue tape over them havent been an issue but lately they feel a little sore and the glue is unravaling....have a doctors appt this Tuesday coming up.....he's the only doc in Virginia that does this procedure and approximately 1 1/2 hours away by car....been getting free transport thru my insurance company there and back....very blessed to have this option....

Okay I've said enuf for now and will keep everyone informed and to all of you a big thanks for sharing and sending healing thots of good recovery for the future

I came across this in my reading.
Hiatal hernias over about 2 cm cannot be treated with the TIF procedure.

BWLake said...
I came across this in my reading.
Hiatal hernias over about 2 cm cannot be treated with the TIF procedure.

Yes it can. I had a 3cm hernia repair and a TIF at the same time.