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Tuesday, January 18, 2011

6 Nissen fundoplication!

I had GERD (gastroesophageal reflux disease).
 And as some of you know, my road started with the hope of living a more normal life, especially with a hope of a more normal diet and less pain.
And as Orison Swett Marden said:“There is no medicine like hope, no incentive so great, and no tonic so powerful as expectation of something better tomorrow”. This is so true for everyone in the health care system.
I asked the doctor in advance. What could I expect. What was worst case scenario etc. I have always believed that when it comes to surgery, we in society today take it to lightly. And I do know that something can go wrong.
My doctor told me that I had a 1 % chance of something going wrong, and the worst case was that i Couldn't eat for a week.
Based on that I took the chance. And today with the laparoscopic procedure it is even a smaller chance of infection, and a faster recovery time.



And of course everything went wrong. I couldn't eat for 3 months. I was through lung surgery, and I was in the hospital for over 4 months.
When I came home we started to look through the internett. My doctor had never heard of esophagus spasms with nissen fundoplication. I Googled it one time, it took me 5 min to figure out that spasms can occur with nissen fundoplication.
I quote: "Our findings suggest that patients who undergo laparoscopic Nissen fundoplication for gastroesophageal reflux disease are at risk for the development of esophageal motility disorders, including
secondary achalasia and DES (esophageal spasms)."1.I think that says it all..
I quote again: "Other complications in this group included two intra-abdominal abscesses, one pleural effusion, one gastrocutaneous fistula, and one right vagus nerve injury."2.
What is the most disturbing to me. is that my doctors at my local hospital saw a density on my right lung over a month before I was put on a respirator, but they didn't do anything about it.
Even to this day, they try to pin this on the botox, even thought I had the botox twelve days after they saw the density on my right lung. I guess they don't want to own up to giving me a Pleural empyema, and almost killing me.
I think that in a country like Norway they should only do this procedure in one place. This because Nissen fundoplication is a complex procedure, and they requires advanced laparoscopic skills.
Again I quote: "complications are directly related to the surgeon’s experience level."3.  At the hospital where I did it, they only did about ten operations a year. And that is to few!
All and all, I do understand that people out there want to get treated for GERD, and I do know that I am probably a very worst case scenario, and nobody wants to become that!



To read more about Esophageal Motility Disorders After Laparoscopic Nissen Fundoplication:
1.   Secondary Achalasia and Other Esophageal Motility Disorders After Laparoscopic Nissen Fundoplication for Gastroesophageal Reflux Disease.
To read more about Mechanisms of Gastric and Esophageal Perforations:
2. Mechanisms of Gastric and Esophageal Perforations During Laparoscopic Nissen Fundoplication
To read more about the Approach Nissen Fundoplication:
3. A Stepwise Approach to Laparoscopic Nissen Fundoplication


6 comments:

  1. I hope you will get well soon.

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  2. Fortunately, I had my Nissan Fundiplication performed by a extremely talented and experienced laproscopic surgeon who teaches the procedure. I had the traditional full 360 degree wrap, 6 centimeters long at the union of the newly disected fundis (not the shorter floppy version preformed by many surgeons today). I could belch without any problem after the surgery. My full recovery time was long - about 5 months until I could eat solid food without any problems. This was partly due to my surgeon's technique of suturing the fundis union to the esophagus; and the esophogial swelling that resulted. But, the pain was well worth it. After 14 years, I still have no complications. I can vomit. I can belch. I have no heartburn and no acid reflux. Anyone considering this procedure should find a surgeon who is a real experienced pro in larproscopic surgery and has experience with the Nissan procedure. Personally, I think the "floppy Nissan" (or short wrap) should be avoided. The longer wrap invented by Dr. Nissan at 6 centimeters is arguably the most durable procedure.

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  3. I am glad that you have such a good effect of the surgery and without side effects at all.
    I do agree that it needs a good surgeon. My surgeon is supposed to be one of the best in Norway, and my doctor recommended him.
    Unfortunately even the best surgeon can make mistakes.
    But if everyone had as good outcome as you did, I think the world would be cured of acid reflux (GERD) :)
    hugs

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  4. I am sorry for what you went through, I know what is have hope. I had a funduplication 6 years ago and I and same place or worst (i don't know) where I was before the surgery. I have pain in my stomach often, I can't belch easily but I have an hernia again with reflux... My GI said that the surgery is not perfect, but without this procedure my symptoms would be worst...

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  5. Thank you for writing :)
    I am sorry for what you had to and have to go through.
    My initial diagnosis was a hernia with reflux which you have gotten back.
    I have read that 6 out of 10 patients who go through this operation are back on Nexium within 10 years of the nissen fundoplication surgery.

    We are always so quick to think that if we hadn't gone through a surgery that went wrong, that everything would have been better, so it is refreshing to meet someone who sees that things could have been even worse without a surgery with complications.

    That you cant Belch must be painful, I cant throw up anymore, so when I am sick it is so frustrating not being able to get it out, I can relate to that ;(
    Other that that, what are you're experiences with the health care system, and what is better with you're life, will they operate you're hernia?? Can I ask which country you are from??

    Hugs Alex

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