Going for a second Nissen fundoplication open surgery

[Maltaguy]

I have done my first Nissen fundoplication open surgery around 6 years ago. All was well in the first years till I was getting back heartburn sensations and besides that end of 2009 after gastroscopy and barium meal was found that one third of my stomach was again herniated and that I was loosing blood..infact was hospitalised with an hgb count of 6.7 last november and was given 4 packs transfusion. Today my hgb is already 9.5 so its getting down again.

To cut it short my Professor told me that I need to do a second nissen fundoplication and this time instead of opening my chest vertically he will do the cut horizontally since he can tackle the problem much better since the herniated part is behind my heart.

I am a bit afraid since reading everywhere it seems that a second nissen is not recommended by most doctors and the consequences of failure is high.

I am 43 years old male.....What are your suggestions ? Am booked for the 23rd of July 2010.

For sure my surgeon told me to forget any laparascopic nissen...in Malta they are totally against it since success is very low so they always opt for an open surgery.

[Smiley2000]

Hi there,

I am only 13 days post-op after Nissen Lap. Fund. so early days for me to know whether it has worked or not.

I think you should go and see a Gastro Enterologist again for some basic tests:  i.e. 24hr PH study or even better (new technology) 24hr PH Impedance study - just to determine how bad the acid/non acid reflux is and from thereon you can get a referral to a GI Surgeon.

All the best and let us know how you are doing.

[teacup1234]

I had a laposcopic nissan fundoplication jan. 2006 for acid reflux. The surgery is starting to fail. I am in alot of pain (heart burn, heart fibulations, esophalgel spasms). H2 blockers, and proton inhibitors don't work and give me bad side effects. I live in florida. Who is your doctor. I need the best , if I am to have a second fundoplication, since they are dangerous. Please help.
I wish only the best for you.
Lynn
***@****

[BoneArt]

I have had two laparascopic fundoplications. Due to complications with the first one where they could only do a partial wrap the second was done 18 months later.
10 Years down the track I have to do it a third time due to acute bleeding along a stitched area from the first one plus a new hernia but this time it will be open not laparascopic.  My understanding is that once it has failed the surgeons need much better access to see and repair it all properly.  My surgeon does 80% laparascopic and is one of  the countries top in both types.  He was adamant that he would only do open in my particular case because it was a redo and additional repair work was likely.
His comment was that for simple and first time fundoplications, laparascopic is prefered but once it gets complicated then open is the way to go.

[selmaS]

Well, I pray u get some answers, u may want to pose that in the heading of the thread....like Horizontal Nissen 2nd try.....it may help get the posters u r looking for.

Good luck and I pray u also get some relief to ur Health issues.
Godspeed
"selma"

[Maltaguy]

I dont think there is any other option than going for my second nissen. Most probably success rate is different between open surgery and laparascopy since on different occassions when I mentioned laparascopic nissen to two different surgeons they both where totally negative about it and even told me not ever to think about it.

As regards the expert forum you are mentioning I have already in the past used it twice and was not convinced with the replies I got from the medical expert since his opinion was always to consult my doctor/surgeon.

From my first post all I wanted was some feedback from people that did this type of nissen that is with a horizontal cut and from those that did a second open surgery nissen thats all.

[selmaS]

HI...I am not a medical professional, but since u r not too sure that u want to have this other Nissan, have u checked into a chiari to manipulate the hernia?

Ask in  the expert forum here on this new non surgical procedure to see if it may be something for u.
http://www.medhelp.org/forums/GERD-Acid-Reflux/show/200

"selma/'