Hill-Nissen Hybrid or Nissen Fundoplication

Hi guys.

I am wondering what your thoughts would be on this. I had a fundoplication last year but it herniated into my chest. Now I am more nauseous than anything, have bad heartburn and occasional reflux.

I have the option of getting a hill nissen hybrid fundoplication with Dr Aye in seattle

or a Nissen fundoplication with dr Pellegrini in Seattle.

They are both very reputable surgeons. The thing is, the hill nissen hybrid is a very new operation, and I havent been able to find any statistics on it. Theoretically it should be more durable but I do not know if this is the case. If anyone has any facts on the hill nissen hybrid operation, thoughts about the surgeons or general comments about the case and could post that would be huge. I just really dont want my wrap slipping or herniating again!! I am a young lad of 22, want this to be for life.

thanks




PS- I know hill is supposed to have fewer side effects (able to burp, vomit etc) but is that the case with the hill nissen hybrid?

Post Edited (AGreatDayToBeAPotato) : 10/16/2015 3:49:34 PM (GMT-6)

Hill is not a fundoplication. Here's an article that shows the different types of older repairs with pictures:
www.nature.com/gimo/contents/pt1/full/gimo56.html

The Hill-Nissen is a combination of Hill and Nissen: /www.youtube.com/watch?v=gOH5O6K7szQ This is Dr. Aye's video. Looks pretty good, but I'm scared of new stuff until there is data.

I wonder though, what would be the outcome if you just had a hernia repair? You said you hardly had reflux. I would get a second opinion just to see if pulling the stomach back down would be enough. If Dr. Aye is just planning on adding the Hill to the current fundo (was it a Nissen?), maybe that would be OK. I would worry, and ask, about the possibility of getting the combined wrap too tight when the stomach is brought back down. I would also ask him how he plans to keep the stomach in place. The diaphragm is not a good place to be attaching anything.

My stomach has, I think, re-herniated also. It was seen above the diaphragm on one scan. I want to get a barium swallow to see where it is. I'm having pretty bad nausea if I eat anything solid. No reflux, which means my wrap is still good.

My esophagus was pretty short when I had my Toupet (variety of partial wrap Nissen). A Collis was considered - see first article) The surgical team "let it down" (cut it loose up inside the neck) and thought it was OK. about 3 months post-op I had a bad vomiting (really just horrible heaving) event that brought up a little blood. I believe I re-herniated then, and now years later, I'm having worsening nausea, feel full after a few bites, and losing weight. I don't have reflux and can't vomit still.

I keep several medicines on hand all the time to stop heaving in its tracks and prevent these herniation events. Zofran is good for nausea, but takes too long to work in an emergency. Donnatal can be helpful, but you may have to take the prescription to a compounding pharmacy. Paregoric (look it up) is the best, stops vomiting in it's tracks. It tastes horrible.

No matter what you go with, it's not for life. If you get 10 years be happy. These events are life-changers. Read everything you can, but remember forums are mostly populated with people who have had problems. We're not doctors, just patients who have had experiences that may not apply to you at all.