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  • Nissan Repair

    Has anyone gone for a reapir to thier wrap? I had my wrap done 5 years ago and still have problems swallowing food and liquids. I am going to Duke tomorrow to talk with a surgeon about gettting the wrap lossened. If anyone has had this done, I would really appreciate any info.


  • #2
    Let us know what you find out, as others here have had problems. One of the board members (David) has had his wrap completely taken down and is doing well. I'm in the process of assessing what is wrong with mine and a possible take down. Keep us posted and good luck with finding your problem.


    • #3

      Wow 5 years is a long time. Have you tried dilations? Can you burp?

      A too tight wrap isn't the only thing that can cause swallowing problems. If the wrap was made too long ..... that can do it too, or a slipped wrap etc.

      Good luck


      • #4
        nissen repair

        Well, I went to the surgeon today and she said that one option is to do a "Floppy Wrap", which pretty much just lossens the original wrap. Taking it down is the other option, but I REALLY don't want the GERD back, so, quandry time. I will have to make a decision soon, I just don't want to rush.

        I have been dialated 3 times, that doesn't seem to help. There appears to be stricture just above the fondo site.



        • #5
          Hi Means, sorry I don't know if that is your name or just your handle. Sorry to hear about your problems over the past 5 years. You are actually very lucky that your surgeon is willing to do something about your wrap by making it a floopy. Did she say for sure she would be willing to take it down as well as an option? It seems like most surgeons are very against the take down.

          I had mine taken down, not 100% down but as close to it as you can get. As I mentioned before I was a bad candidate and I had a surgeon who recommended a surgery I didn't need. I had very, very mild GERD, but a big time burping problem. Somehow the genius thought that preventing me from ever burping again would cure me problem.. wrong. If you are interested in reading my "Saga" ...LOL leading upto the take down it archived on this site under a posting called "Considering a Fundo Take Down" probably towards the back pages.

          Anyhow if you had serious GERD like most who had the fundo I can certainly understand why you wouldn't want that back. Maybe the floppy is the best solution for you.

          Keep us in the loop on your decision I'm eager to hear how it works out.



          • #6
            nissen repair

            Hi Dave! Thanks for you comments and advise. The surgeon is not sure that the floppy will solve the problem - have to cover those butts!! But at this point there doesn't seem to be anyother solution. She is reluctant to do a take down, my symptons where pretty severe and I had some damage to my throat from all the acids. My original surgeon did a great job on the wrap, but I guess the damage to my throat caused this side effect.

            It is all very confusing and not a little scary - I don't want to return to the pain, but I want to sit down and enjoy a meal without it getting stuck or worse!!

            I'll let you know what the final decision is and if I go for the floppy what the outcome is.

            Thanks again for your support.

            Last edited by nmeans; 06-11-2005, 08:25 AM. Reason: spelling


            • #7
              Just wondering what a "Floppy Wrap" involves?
              A super dilation, or going in there and doing some stitch loosening?

              Glad to hear you are doing good David


              • #8
                nissen repair

                Hi Robert,
                A floppy wrap is when they lossen the fundo. There is also a "toupee", which is a fundo only it is wrapped about 3/4 of the way (from the photo the dr drew it looks like a boppy pillow for babies).

                Hope that anserwed you questions!



                • #9
                  Hi Nancylynn In order for someone to have a fundo re done floppy, wouldn't the the wrap have to be taken down and redone.? Nevermind, it would It's not a matter of just loosening up the stitches. A floppy wrap is tension free as well as loose. You have to unwrap the stomach around the esophagus, make adjustments, and then wrap it over again.

                  the short gastric vessels have to be taken down to make a floppy wrap , that's basically what makes a floppy wrap . .... It's a wrap that doesn't create tension on the esophagus ....... once the vessels are taken down, everything will be re wrapped looser, and tension free. The wrap is also usually made shorter.

                  Most surgeons do a short floppy wrap to begin with. Virtually noone does a high tension , tight, long wrap anymore .


                  • #10
                    nissen repair

                    Thanks Tricia - I was going for the short version of what my dr is going to do. (my typing ability is very limited!!!) I like your explaination much better. Have you had a floppy? I am a little nervous about the redo and would love to hear from anyone who has had this done.

                    Thanks, Nancylynn


                    • #11

                      Hi Nancylynn No I have never had a Nissen , but it is safe to say the majority of people who have had the fundo , have had the floppy nissen. They first started doing hem floppy in the 70s, because they discovered it alleviated a lot of post op problems such as swallowing troubles .

                      David, for example had a floppy, but he had his taken down . But then again , he wasn't a good candidate to begin with.

                      Not sure if a redo would help you, it depends on the cause of your swallowing problems. Did you have swallowing problems before the Nissen? Or did it just happen as soon as you got the op?

                      Are the swallowing problems also related to the way the Nissen was constructed ? Or are the swallowing problems only related to the stricture... or both? Or from a motility disorder? Is GERD back? Is the stricture from acid because GERD is back ? Or is it related to the op, or something else?

                      Have you had a ph test lately ? Motility test? Make sure there is no motility disorder contributing to your problems in which case the op may not help . Was your motility ok before the op? Have you had a barium swallow?

                      I would say those questions would have to be investigated extensively before proceeding. I'm uncomfortable with the surgeon saying she is not sure the op would help ., this would make me think she isn't sure as to all of the factors which are causing the swallowing problems.

                      If the way the fundoplication was constructed is the major reason why you are having problems, , or GERD is back, then the redo should do wonders for you if done well. If there are other things involved , then the surgery may be contradictory.

                      There are a couple of people who had successdul redos in the forum and are very happy. Hopefully they will post. If not, do a search on Nick , he is one of them. But remember, everyones problems are different . Good luck to you


                      • #12

                        I have had 2 redo's and am doing pretty well now. I had the redo's because both times they said my hietal hernia has recurred. I was having quite a bit of chest pain. Never had any problem swallowing beyond the first couple of weeks. The second redo was an open procedure in case there was a lot of scar tissue. The surgeon also wanted to visually see and touch my insides to see if there were any other problems. I think he was looking for an i-pod he lost about the time of my previous surgery, haha.

                        Anyway, I don't feel that the redo's are any more of a problem than an initial fundoplication. That is only based on my experiences. It testing reveals that it truly is not functioning any more, I highly recommend a redo.

                        I have been heartburn free since my first fundo in 2001 I think. I had 2 or 3 times when I wondered if I was having heartburn but I really think it was something else. I have had no ppi's or antacids since my first fundo either. (maybe 1 or 2 rolaids in search of pain relief)

                        Good luck and make sure testing reveals results that would justify a redo. I would hate to go through that and it not be the problem. After my open redo, the surgeon came in the hospitol room and told me that he didn't find 1 thing wrong. He said everything looked perfect. But he also said he tightened the wrap a little just in case. Oh well. Waste of 6 months recovery. In hind sight I wish I had been more patient. It was less than 1 year from my 2nd to my 3rd. But I got a second opinon from Duke University and had PH, Manometry, and CT Scan. They recommended I have a colis Gastroplasty to lengthen my esoph. Then when my surgeon went in for the procedure, "everything looks perfect" so testing is not always accurate.

                        I think I am rambling. Anyway, I am recovering nicely. My last has been about 18 months and I am beginning to feel fairly normal. I just have episodes lasting about 1 week every so often. Pain in abdomen and chest. Heart checks out great. Ct scan 2 weeks came back ok. Only said I had scar tissue, small cists on my liver, and maybe a little darvaticulitus. Nothing unusual he said.

                        Ok, I will "shutty" now.

                        Good luck. No, good perseverence and patience would be better.


                        • #13
                          Hey Phil,

                          So are you saying that you had two repairs that you didn't need due to false results due to testing? My fundo is fully intact but has broken down and formed a pouch. I have soreness and burning (occasionally)...mainly soreness in my esophagus. I had a Bravo PH test which came out normal. The doctor sez it's still working but if I can't handle the sorness/burning I'm having that he can send me to a surgeon to fix my fundo. I hurt mainly at night and I sleep almost at a 90 degree angle. Oh, and no meds work for me. I've switched to a new doctor for his opinion and I will see him on Thursday. I had been seeing an Internalist. I switched to a GI specialist. I don't know if I should have it fixed or not. I'll see what the doc has to say on Thursday.




                          • #14

                            No. My first redo was needed as my hernia had recurred. I thought it had happened again but my last procedure that was open proved everything was intact. The 3rd surgery was probably a total waste. I still have soreness in my esoph. but it seems to be less frequent and less intense as time goes on, for me.

                            Have you tried any medications like Buspar or Elavil? I used Buspar for a while and it helped. It seems the doctor thought my nerves were firing for no reason and sending false pain messages to my brain. I had zero side effects from buspar. I even considered trying neurontin but read that the side effects were unpleasant and it causes weight gain. I don't need more appetite. I believe it is critical that after the fundo, our weight is maintained carefully to prevent unnecessary pressure on the wrap.

                            Buffy has been having problems with pain post fundo and told me that she just started taking elavil and it seems to be reducing the pain.

                            Just thoughts.

                            I don't know if you know me or not "waiting" but the main reason for my surgery in the first place was that I was no longer able to sing. Therefore I had little reason to breath. I was devastated. Now I am singing again and that is worth it all.

                            My situation is probably totally different than yours particularly since yours is 5 years old. Still if I were you and the doctors convinced me with proof, that a redo would very likely ease my suffering and improve my health, I would do it this afternoon without hesitation. None of the surgeries were awful for me. My biggest problems were the catheter and after my open surgery, the drain was really painful to remove. Otherwise it was a piece of cake. (tolerable)


                            • #15
                              Thanks for the info Phil. What kind of medicines are Buspar and Elavil? I'll ask my GI specialist what he thinks.

                              What kind of singing do you do? I'm glad to hear you've got your voice back. That's a tremendous outcome.

                              Thanks again!