Redo....

Hi cmac --

Sorry to hear of your difficulties. There is a lot of help available to you on this messageboard.

If I might make a suggestion, add to your previous post. That way, others may contribute to your thread while reading what has already been offered by others, and there isn't a need to repeat important facts and/or symptoms. Plus, it keeps the messageboard a little more tidy and not so cluttered with duplicate threads.

Welcome to the group!

-Bruce

The last surgeon did a good job though, it did last 3 years until I over excerted myself, and who would the best surgeon be? I live near DC so john hopkins and all of that is in reach for me, what made you draw the conclusion to get a redo??

Cmac,
I just had my redo yesterday - so can't really say if it will hold but my last 24 hr impedence testing showed 81 episodes of reflux so I definitely needed it done. In thinking about testing - Bravo only measure acid so in my case (since i was on an acid suppressor) it didn't show much - my reflux although almost continuous is non acidic. My surgeon was impressed with my impedence testing though :)

cmac-if i remember correctly the impedence test is like the motility but you keep it in for 24 hours.  It's horrible but it gives the most accurate reading.  I am also contiplating a redo but keep putting it off because of these tests.  I actually think it's worse than the surgery.

Cmac,

First, you have to establish you are truly refluxing, and that would require an endoscopy, 24 hr ph monitoring, or implanted Bravo device. If it is determined you are refluxing to a degree causing GERD, then you would decide if you wish to undergo surgery again, or just try to live with a daily PPI medication. PPIs don't work for me, so I may go ahead with a redo after my endoscopy scheduled for the last week of December if it is revealed I have severe reflux. If you were happy with your first Nissen, I guess you could go with the same surgeon once again. Then again, I doubt you could do much better than a Johns Hopkins surgeon.

Not all hiatal hernias cause reflux. In fact it is said, "not everybody who has a hiatal hernia will have GERD, but everybody who has GERD will have a hiatal hernia"

Cmac,

There are only 3 sutures holding the fundus area of your stomach around your esophagus, and you could have possibly popped a suture or your wrap could have migrated up or down your esophagus so it is no longer wrapping the LES. There are many possibilities and only diagnostic testing will determine what your problem is.

It is my understanding during a redo, the prior wrap is taken down, the correct boughie (spacer) is put down your esophagus to the location of the LES, and then the fundus is once again wrapped around your LES and sutured in place. I'm sure this is a very simplified description of what actually happens during a redo.

It is my understanding an original Nissen will last 10 years before requiring a redo, but then again, I've also read over 60% of people who have Nissens are back on Proton Pump Inhibitors not too long after their first Nissen.

It's such a fine line for the surgeon to walk. Make the Nissen too tight, and the patient has difficulty swallowing and bloating problems. Make the Nissen too loose, and the patient has continuing reflux.

To answer your question, I don't know why a Nissen Redo wouldn't also last ten years if performed by a competent surgeon.

I think you just have to be very careful, and if you discover you did damage your original Nissen while doing preacher curls.......if I were you, I'd give up on weightlifting following a redo.

I've read stories of patients damaging their Nissens by vomiting after surgery, and I read a story of a guy damaging his Nissen by drinking excessive amounts of beer shortly after surgery, so it seems anything is possible.

You're lucky you had three good years after your Nissen. From day one, I don't believe my Nissen was made tight enough, and I've had three years of discomfort.

Yes my friend that would be greatly appreciated the weird part is they are having trouble pin pointing it, the one endoscopy says it seems slightly loose, the barium swallow didnt reveal any damage. On my endoscope i had done recetly my esphogaus looked pretty burnt up and mouth burns too its hard to eat, I would really like to know about that surgeon...this is pretty bad.

dongar, can you tell me the name of your surgeon? I also had a surgeon in Northern VA who does over 100 per year. Perhaps it's the same one???

Same here, haven't gone trough nissen yet but want to know exercising limitations

Well I have had 2 redos, but not because of anything normal. My redo surgeons told me they expect it to last 10 years plus. My last surgeon told me they usually say 10 years because that;s basically the average since it was first done. He did say that with the advancement of techniques today he thinks they would last more like 15 years or more. Now that is just his opinion without any documentation.
As for whether the failure rate is higher with a redo I believe that depends on the skill of the surgeon doing the redo.

Take care,
Bill

speedy-

I've had 3 and Michelle is going for her 4th. My only problem with any more redos is that it will have to be done open because of the amount of stomach and esophagus surgeries I have had.

When they thought I would have to have mt esophagus removed last March, the surgeon was concerned the stomach might not function completely normal(area of fundus for wrap).

My last surgeon said everything looked good after he cleaned up the scar tissue and my wrap was completely tore apart. He said it went back together perfectly and said If I need another one there shouldn't be a problem.

Take care,
Bill