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Doctor insights on: Nissen Fundoplication Surgery

It is more difficult: To undo a nissen fundoplcation than to do it. After creating a nissen fundoplcation, it gets really scarred in place. To take it down puts the distal esophagus and gastric fundus at risk for injury. The only reason to consider taking one down is intolerable gastric bloating with inability to burp or vomit afterwards. And you have to consider why the fundoplcation was done in the first place. ...Read more

As any other patient: It mostly depends on your genetic predisposition and drugs used by anesthesiologist, then procedure itself. Theoretically eye procedures and gyn surgeries has higher incidence of nausea, but with modern drugs, it is not significant as in the past. ...Read more

Combining surgeries: Usually makes the surgery longer, causes more complications, increases healing time and increases the risk of bleeding or infection. As for healing - ask your surgeon usually at least 6-8 weeks. ...Read more

Tests are available.: For all surgical procedures there are risks and benefits. With nissen fundoplication and hiatal hernia repair, vagus nerve injury is a known risk. The risk for vagus nerve injury is due to the proximity of the nerve to the anatomy in which the procedures are performed. Okay to discuss with your surgeon and the GI doc on your team. There are tests to diagnose vagus nerve function. Good luck. ...Read more

Time will tell: Depending on the surg and the swelling in the area of the phrenic nerve, time is the only way you will get an answer.
There is no way to make an prediction. ...Read more

See a GI Surgeon: Absolutely, that can happen within a limited timeframe after the original surgery, however, depending on the way the fundoplication was done, you may have lost the ability to burp due to the completeness of the surgical wrap around the base of the esophagus. It takes another surgery to 'relax' the wrap to allow gas to come up, or burp, if that is the issue. ...Read more

Talk to surgeon: Any change during the post-op period should be taken seriously. Have the surgeon on call paged to discuss with them what you are noticing or have her seen in a local ER to ensure that she is okay. Best wishes. ...Read more

Consult your surgeon: Highly like your Nissen has come undone and need to be revised ...Read more

Record diet: You had a nissen and now notice gas. Try recording what you eat and avoid the food that gives you gas like fried foods or legumes. With your nissen you may have received antibiotics. It will take a while to return your gut flora to normal. You may find that yogurt often can help so give that a try. ...Read more

You should: Speak with the surgeon who performed the operation. The average pediatrician will not know the answer to this question, and it's best to ask the surgeon who has likely performed and followed up many of these types of cases. ...Read more

Yes!: This is the most common anti-reflux procedure, involving closure of the hiatal hernia and re-creating a new valve by wrapping a portion of the stomach around the esophagus. While very effective, this procedure is reserved for the rare patient who cannot manage their symptoms with lifestyle and dietary modifications supplemented by anti-acid medication. An incisionless option, tiff, is available 2. ...Read more

See a Surgeon: Basically, if you have documented reflux disease either by history or testing such as egd or ph probe test, then fundoplication can be considered. Medications can help with reflux, however if you are young or the risk of surgery is minimal, the fundoplication can keep you from needing to take medications for your lifetime. If medications don't work, then surgery can be considered. ...Read more

Depends: Whether you are a child or adult and any concurrent medical problems. If you are a healthy adult without comorbid medical illnesses it is about the risk of General Anesthesia (<0.1%) ...Read more

Yes: The procedure is used to treat REFRACTORY GERD (poorly responsive to MEDICAL Treatment)
The surgeon will describe possible complications of the surgery including bleeding, obstruction etc.

Hope this helps!

Dr Z ...Read more

Yes.: When performing a nissen fundoplication, the esophagus is only marginally affected. Therefore, following reversal your esophageal function should return to your pre-surgical state. This is best determined by a motility study. ...Read more

Talk to surgeon: It is laparoscopic surgery to decrease reflux of acid into esophagus. Discuss with your surgeon. ...Read more

Would think so: See: http://usmilitary. About. Com/od/joiningthemilitary/a/abdominal. Htm

Bloating: Bloating is very common after reflux surgery you can over come that by eating multiple small meal eat slowly and chew your food very well cut your meat to a small bite keep your bowel regular and do a lot of walking stat on anti gas medicine ...Read more

Varies: The fullness can be highly variable. How tight vs how lose the wrap was made, how much postoperative swelling is present and the length of the actual wrap can play a role. Generally, patients will reach a baseline 3-4 months after surgery when all the swelling is gone. If the wrap was made to tight, the patient may have long term problems with swallowing or excessive fullness. ...Read more

Ask your pediatricia: To be honest although I am not a pediatrician it is normal for a baby to regurgitate so I am unaware you should do this surgery on infants. ...Read more

Nausea: Can make a baby cranky after Nissen because she cannot vomit. Take her to her doctor to be sure there is nothing else wrong and if cleared ask to try an antinausea medication. Other possibilities include breakdown of the surgical procedure or a post operative complication so do not wait before seeing the doctor. ...Read more

Done for severe GER: All young infants have some gastroesophageal reflux; that's why they spit-up. At 4-6 months' age, the lower esophageal sphincter becomes more competent, and reflux usually subsides. If it continues and causes severe problems with the respiratory system (stopping breathing, recurrent pneumonia), poor nutrition, or direct esophageal complications (inflammation, stricture), surgery is considered. ...Read more

Very short time: With in 2 wks you should not be taking pain medications after fundal plication surgery. ...Read more

No: Reflux surgery is to decrease acid reflux, not for weight reduction. ...Read more

Why: Why you want to reverse the fundoplication, do you have problem?
Everything possible, but most surgeons that I know they have to have an indication or a reason for surgery ...Read more

Surgery will help: This is a tough question and still being looked at. The data so far does show that antireflux surgery)does shows some regression of short amounts of Barrett's. It has also helped slow the progression of Barrett's to cancer. However it does not eliminate the need for continued surveillance. Consult your physician on that. If a hiatal hernia repaired it may also help with future Barrett tx. ...Read more

None: After a fundoplication, I'd advise against it. ...Read more

Hiccups post Nissen: This is likely related to ingesting air. Many reflux patients swallow air. This behavior must be "unlearned". It often resolves with time but takes months. Delayed gastric emptying is also possible. Try simethicone to see if it improves symptoms. Also avoid carbonation, gum, straws, raw veggies, and crunchy foods as these all increase gastric air swallowing. ...Read more

No: There should be no link. May need test to make sure nissen still in place. ...Read more

Can't burp: An effective nissen fundoplication provides a barrier to gastroesophageal reflux, but also a barrier to vomiting and burping since the lower esophageal sphincter no longer relaxes to let air (or other stomach contents) escape upward from your stomach. The air then accumulates in the stomach, resulting in gas and bloating until it can be evacuated into the small bowel. ...Read more