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Surgery for Hiatal Hernia Repair plus TIF

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Posted 1/16/2013 8:33 PM (GMT 0)
After an endoscopy with a gastroenterologist, I was just diagnosed with a large 5 cm hiatal hernia, 2 non-bleeding esophageal ulcers, multiple benign gastric polyps (larger polyps removed), and arytenoid erythema. The doctor has me on a special diet to heal the esophageal ulcers for 8 weeks. Then a repeat endoscopy or TNE to make sure the ulcers are healed before having a surgeon specialist repair my hiatal hernia, and the gastroenterologist perform TIF during the same operation. Has anyone had these two procedures done? I am concerned about having TIF along with the hernia repair. Maybe I need a 2nd opinion? If anyone has any information and/or links to share, I would appreciate it very much!
Posted 1/19/2013 7:54 PM (GMT 0)
Hi PBMO,

Seems that you have quite a bit going on for you right now.

I would not suggest going with the Esophyx TIF as the long term outcomes were really not that wonderful.

Many people had to go back on the PPI's.


You might wish to consider the LINX procedure (as I am) since TIF is not reversible and there have been a few reports of perforated esophagus. I went to a MD who specialized in the procedure and while the concept isounds cool, I tend to think that is it way oversold.

I was also informed that the success rate is about 70%. You might want a second opinion on it.

Just my thoughts.

Get well.

Gastricman :-)

P.S. The LINX is prcedure is indicated for a HH of =< 3 CM, so I wonder if the correction for the HH can be performed first and then (in the same surgery) the LINX. I have not been able to get a factual answer on this question just yet. Contacting Torax Medical, the manufacturer of LINX, might be a good start.

Here are the company links for the USA and UK:

http://www.toraxmedical.com/linx/

http://www.toraxmedical.co.uk/

Here is a medical inquiry site in the UK (doesn't hurt to ask) - http://linxrefluxsurgery.com/

 

Post Edited (Gastricman) : 1/19/2013 1:19:41 PM (GMT-7)

Posted 1/19/2013 11:16 PM (GMT 0)
I went with a top thoracic surgeon who does Nissen and it's varieties depending on the individual needs of the patient. He claims a success rate in the high 90% range. As long as you have to have the hernia repaired I would go with the tried and successful procedure.

Definitely get a second opinion. I'm glad I went with the recommendation of my gastroenterologist to consult an expert.
Posted 1/20/2013 12:57 AM (GMT 0)
Hi Alcie,

Would you like to share the name and location of this surgeon who promised in the high 90% range?

What kind of Nissen did you have (and was it done via LAP) and how long ago? How are you doing now?

I'm curious to know how he is achieving this high percentage of success!

Mine only offered 80-85% and he does it via LAP/Robotically.

TIA,

Gastricman :-)

 

Posted 1/20/2013 5:55 PM (GMT 0)
I had Nissen fundoplication laparoscopy and hiatal surgery repair for a 6 cm HH on 12/4. I have done very well.
Posted 1/21/2013 12:48 AM (GMT 0)
Here's an article on GPEH repair outcomes over the last 10 years. My surgeon was the first author of the article. Other posters have been to this center. You can look up threads by putting some keywords in the search box at the top of this page.

Note that GPEH is more severe than just a hiatal hernia. The stomach is stuck in the chest.
Posted 1/25/2013 3:38 PM (GMT 0)
Thank you, Gastricman, for your info regarding the LINX. Please keep in touch with any additional info.

I am now on a special diet for 8 weeks or so, to heal the two non-bleeding esophageal ulcers, and I feel great now that I am not eating my favorite foods with spices, tomato sauces, citrus, etc. In the meantime, I will be researching my options carefully before undergoing any surgery, and get a 2nd opinion.

If anyone has any referrals to specialists in the Los Angeles or Ventura County areas, please let me know.

All the best to all of us out there going through this. This forum is great!
Posted 1/26/2013 12:35 AM (GMT 0)
Oops. I didn't put the link for the outcomes study in my post.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2813424/
Posted 1/26/2013 1:56 AM (GMT 0)
I have had three Hiatal Hernia repairs. The first in 1994 at VA. Then they cut you from the belly botton up. In 2009 on June the 9th I had another repair. On the 11th They had to back in because they said I had a leak in my stomach. They also put in a mesh at this time. Now I am having problems again, after CT scans and Barium Swallow test, said I had a small Hiatal Hernia and a loosening of the wrap. They have set me up with one day surgery with a scope. Does this mean they will make a cut and insert a scope?
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