Laparscopic Nissen Fundoplication and Hiatal Hernia repair surgery

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I had suffered with stomach problems for what felt like forever but was probably just a year or two before I finally insisted on seeing a specialist (Nov 13). I have previously been taking Esmaprazole, Domperidone and copious amounts of Gaviscon to no real avail. I suffered acid problems and a constant burning sensation in my upper abdomen. I had Laparscopic Nissen Fundoplication and Hiatal Hernia repair surgery in June 2014 and could feel the improvements from the moment I came round from Anaesthetic.

I thoroughly researched the surgery, recovery and surgeon’s available and even considered paying privately if the need required. By request I was referred to Mr Viswanath (James Cook University Hospital & Nuffield Hospital – North East England). After reading some of the blogs and information available on the Internet regarding this type of surgery I was under no illusions that the recovery would be very tough, Indeed my own GP advised me against this type of operation as did most of my family and friends however the pain and suffering was to such an extent that I knew I had little option but to undergo surgery.

I am very pleased to say that for me, the recovery has been less difficult/painful than I was advised, I put this down to two factors; firstly and most importantly the skill of the surgeon, secondly by being mentally prepared (remember that any discomfort and dietary restrictions after the operation are a temporary measure in order to fix your stomach, and by comparing that to the constant discomfort I was suffering Pre-Operation encouraged me to be positive each and every day).

I had never before experienced a hospital stay or surgery or anaesthetic and was very nervous however I can honestly say (to date) the hardest part for me was the thorough testing carried out to check if I was suitable for surgery and also the 24 hour fasting/dietary restrictions pre-op (an empty stomach for me was a truly painful thing - the acid was unbearable).

My surgery was first of the day and I was given the anaesthetic at 07:50, When I awoke from anaesthetic at 10:50 I was asked how I was feeling etc and if I was in any pain/discomfort, I wasn’t and asked for some water which I was given at hourly intervals on an incremental basis. After my first sip of water I managed a small burp (for me this was a major sign of the surgery’s success, I had read many blogs in which people were never able to burp again and therefore suffered from gas). I wasn’t in any pain/discomfort nor felt groggy in any way, in fact the constant nagging pain that I had felt pre op was gone. I managed to visit the ladies without any assistance walking and was discharged shortly after 17:30pm the same day. Amazing!! Unfortunatly another lady in for surgery the same day as me was not so lucky, when she awoke she asked for pain medication and when I left she was still struggling to swallow even the smallest amount of fluid. (I put this down to the pain medication but I’m not medically trained and am not qualified to say).

I was discharged with Tramadol pain killers to be taken as required alongside paracetamol, anti-sickness medication and Lanzaprazol (all dispersible). I took half of the Tramadol on the second day thinking it would help me sleep as I was finding it difficult to get comfortable lying down because of the wounds, but it didn’t and so I didn’t take any more. The first few days I took paracetamol every four hours along with the anti-sickness and Lanzaprazol but around day 5 I didn’t feel the need and only kept taking the antacid at doctors instructions (so the stomach has time to heal without acid causing any problem).

Food was limited to liquid only and I admit to following the dietary information very comprehensively (My advice if you want it - this is your chance to fix your stomach – don’t waste it by trying to run before you can walk). I kept a daily log of my food intake and although the first few days I managed very little, a small amount of yoghurt, ice cream and soup this soon increased as the week/weeks went on and the food diary helped me to monitor the improvement easily – which also helped boost my moral/positive attitude. Although a liquid diet sounds very restrictive, a little preparation can go a long way to making this diet easier and more acceptable. I made several batches of soup pre op, different flavours and thickness and froze them in different quantity pots – labelling them clearly, I bought several types/flavours of ice cream, and yoghurt’s and also drinks e.g Bovril, Hot Chocolate, Ovaltine and Horlicks and used full fat milk. I bought various tins of deserts e.g Custard, Semolina, Tapioca, rice pudding and thinned these down with full fat milk. By week 3 I was managing small amounts of soup with small bits and also a rusk with a cup of tea. After week 6 I stopped recording my food intake and continue to increase my intake on a slow and steady basis.

I’m not saying the recovery has been easy and there were/are times when it is difficult to swallow food and I know I still have a way to go, it’s still early days and as my intake is reduced so is my energy levels but in all I would say this was not as difficult and unpleasant as I had thought, and for me it was a big success and my life is much better for it. I am thrilled with the results to date (11 weeks on).

I would like to mention that I am pleased with the service received from the National Health Service, from the point of referral, through consultations and thorough testing to the date of my surgery took under 7 months. I couldn't fault the care received. Again I would mention the skills of Mr Viswanath and his team in helping to give me back my health.

My advice to anyone suffering - If surgery is a viable option for you then do your research & choose your surgeon, remain positive and follow the instructions given to aid your recovery. Don't be put off by the information available, there are success stories too. Best Wishes, Julie.

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  • Posted

    Dear Julie.  Just read your very informative post.  I don't know whether this thread is still live but I would love to know how you are getting on now?  I have a hiatus hernia and severe acid reflux for 7 months and cannot bear the pain anymore. Am being referred to GI specialist and have read so many horror stories and tales about people having to fight to have the operation.  I know it is a last option and not to be taken lightly. I would love to hear from you if you receive this post.  Thank you.
  • Posted

    So pleased for you that it's worked for you.

    l had the same op, one year ago and all was fine at first,, have a bit of reflux but nothing like it used to be, however l am experiencing diarrhoea as soon as I eat, not happening all the time, done a log of what I've eaten, but nothing is showing up too what is causing it, just wondering if it's down to the op, going to have the camera down and up in April.

    have you experienced anything like this?

    • Posted

      Ann, your problems could be related to gastric dumping syndrome from eating too much or too quickly rather than the composition of the foods?

      The stomach is smaller and fills quicker than we realise. It can then dump its contents too soon into the duodenum. In more extreme cases, this can cause symptoms similar to diabetics of sweating, palpitations, disorientation and even blacking out. But your stomach will slowly continue to exand and cope with the problem. I have experienced all these symptoms following my Collis-Nissen revision 2 years ago; my stomach has taken all this time to get nearly normal.

    • Posted

      Only eat small bowl of  porridge one day and within 15 minutes get diarrhoea, next time l eat porridge and I'm fine, l can't pin point what is causing the diarrhoea, it can happen for 3 to 4 days, then stops for a little while, then starts again.
  • Posted

    Hi Julie

    I am on a waiting list for surgery.

    The surgeon told me it's 4 month waiting list for surgery.

    I had a Barium Swallow done first as was scared of having

    Endoscopy. I had to be sedated for Endoscopy test done as

    could not bear thought of just being able to sit there and have

    done saw my surgeon Mr Menzie he siad was a candidate for

    surgery as I have 5cm hiatus hernia and reflex Gord.

    I was put on his surgery waiting list then which is about 4 months.

    I was then sent to have manometer. which I told surgeon I really

    didn't think be able to go through with but due to wonderful staff

    they got me through the it . I had the thicker monitor not the 24 hrs one

    Was not the best experience in my life but staff were very caring and Good

    i got through to it which is didn't think be able to.

    I will be seeing surgeon again 28 April before surgery .

    I don't have date yet but trying to read up on what to expect.

    Getting nervous but reading what you have said is good as was

    worrying about recovery. Especially about eating again after.

    Wasn't sure what best type of food when you on the liquid diet or

    what stuff I should avoid. I'm sure he will tell me more when next

    see him. But be helpful if I can get any questions I need to ask

    him before the surgery.

    Hope all goes as well for me as it seams to have gone for you.

    Reading has helped some what. I was told be on liquid diet for

    about 2 months and expect to loss some weight and to eat small

    meal frequently

    Special knowing what to get in for eating and how others cope.

    My Surgeon I'm under is Mr Menzie.

    I belive it will be done at Ashford and St Peters Hospital under

    the NHS as this is that area is live. If you can give me any more

    tips on how to cope after.

    I was told I will be off work for about 10 days but will feel bit

    weaker as will be on liquid diet for 2 months or there abouts and

    Will need to haves small frequent meals.

    How are you getting on now as I belive your surgery was a year

    ago now so be interested to now how things gone and are you

    able to eat normal again yet...

    Thank you for the information you loged think has helped me get

    My head around it all.

    Kind Regards

    Zena

    • Posted

      Hello Zena

      I was so pleased to read your blog as I am also under the care of Mr Menzies at St. Peters. I am also worried about the operation and also dont't have any info on how good Dr Menzies is! I Assume you have had your op now and hope you have had a good result and are feeling well. Please let me know about your experience.

      Kind Regards

      Sheila

  • Posted

    Thankyou for such an informative and positive post.

    Im 63 and have been suffering with Reflux and a HH for years.

    At the start I only felt ill after eating out or even going to a party. I tried not eating, eating, not drinking, drinking, eating before I went out, sleeping before I went out but nothing worked, so I stopped going out!!!

    Now... Well, I now feel so unwell and uncomfortable daily. I have breathing problems even if I get up from the sofa and climbing the stairs is challanging.

    I cant burp or vomit. I get to the wretching stage with a fountain of saliva then as I heave all that come out is noise!!!

    I had an emergency op last September to remove my Gall Bladder but this did little to make my reflux better as I have a low fat diet anyway.

    I also have Fibromyalgia which I could cope with had I not got a HH and Barretts.

    I had to stop work 2 years ago and now get tired and uncomfortable doing most things and can only spend a max of 20 mins in the garden and have set up a table and chair so I dont have to bend too much.

    I am booked to see a GI consultant at Coventry University Hospital on June 14th.

    Its taken an age to get to the this point with around 5 endoscopies, a barium swallow and trying all the drugs available.

    Im on Tramadol and Amyltriptaline ( for Fibro) and Esomaprozole, which helps with the heartburn but doesnt relieve my other symptoms.

    I remarried in July 2013 and my poor new husband has coped with this condition wonderfully, but Im not the woman he fell in love with!!

    We are going to Spain in a week and it fills me with a little dread. A year ago I had a severe reflux attack on the plane on the way home and had to spend 2 hours sitting bolt upright trying to control my breathing and the need to be sick.

    I do find that if I can get to bed and get to sleep lying on my back, my symptoms get better only to return when I eat.

    The maddening thing is the size of my upper abdomen, it looks like I swalled a foot ball and my weight gain is depressing... 

    I so hope that the Consultant will agree to doing the Op... my life isnt worth living at the moment and this is NOT what retirement should be sad

    Im sick and tired of feeling unwell and almost housebound...

    I want my life back please and long to enjoy my new and joyous marriage! sad

  • Posted

    I had this operation on 4th may 2016 after suffering for over 3 years with acid reflux that tablets only partially controlled. After much research I decided to go ahead with the nissen fundoplication thinking the operation if a success had to be better than a lifetime of medication. My surgeon was very good and made it quite clear that risks and complications that came with the operation and even the morning of the surgery was giving me the option of changing my mind. I went ahead with the operation and unfortunately during laparoscopic way the operation had to be converted to fully opening of the stomach due to a splenic bleed. I spent a day in intensive care and a further 6 days in hospital and have never known pain like this, even 3 c-sections couldn't prepare me for this. I still however feel it was the right choice and that even though my recovery is going to be an awful lot longer than expected I haven't had to take an medication for reflux since the morning of my operation. Anyone thinking of having this procedure should definitely do an awful lot of research, try and talk to others who have had it done and ask the surgeon their success rate with patients who they have performed this operation on. Mine had a very good rate and unfortunately I was the only person in 5 years he had to convert to fully open the stomach ☹ .
    • Posted

      Hi, you are very brave. I have my date for FUNDIPLICATION and Hiatus Hernia repair for June 8th I have read so much online, this forum I have found helpful, I'm terrified about it all but like you I feel the results will be better than meds and symptoms I have suffered from for what I can only remember as alk my 46 years on this earth. I wouldn't say they are totally life limiting, but the constant phlegm, cold like symptoms in my nose, chest pain and nausea, I think I'm doing the right thing. I'm self employed and worry a bit about recovery time, I'm aiming for 6-8 weeks. I'm a housekeeper for several house's which I've had regular for over 16 years so all my ladies I clean for are quite good about me being away for the time..

      Good luck with the rest of your recovery.

      Margaret

    • Posted

      Hi Margaret. Thank you for your kind words. I'm sure you will be absolutely fine in your operation and it may not feel like it immediately after your operation but give it time and it will probably be the best decision you made. One of the things that I kept finding when researching was that the majority of people, given the option would still choose the operation over a lifetime of medication and reflux symptoms. Also if your operation is managed to be done by keyhole surgery you will probably be well recovered before 6-8 weeks. They originally gave me about 3 weeks recovery if done by keyhole and about 8 weeks now they converted it to fully opening the stomach. Just take each day as it comes, keep on top of your pain relief and start by eating very small portions of pureed food a few times a day, imagine it as feeding a baby their very first food and slowly progress in thickness and quantity to prevent bloating and stomach discomfort. Good luck for your operation. 😊 xx
    • Posted

      Hi donnski,

      I have just come across your post. The exact same thing happened to me.. The surgeon went in laparoscopically and cut my spleen, after trying to stop the bleed for an hour another surgeon decided that I would have to be opened up. I too was in intensive care and had 5 pints of blood transfused. Obviously with open surgery it can create quite a lot of other issues, infections clots etc. how do you feel now?? I am 8 weeks Post op. I'm having issues with nausea and constipation- have you suffered these? Due to being opened up symptoms u present are different from laparoscopic so it's nice to be able to swap stories..

    • Posted

      Hi, so sorry the same thing happened to you too, we must be the unlucky ones. The actual cut all down my stomach is healing well and isn't too sore but just to the left of it is very uncomfortable, hoping this eases soon. It is 13 days since my op now and I'm also having problems with constipation and this morning felt quite nauseous. How has your appetite and eating been. I haven't felt hungry since the op so feel like I'm forcing myself to eat small meals 4 or 5 times a day and they are small. Not found any problems swallowing but do feel like it all sits very heavy high up in my stomach and just below my chest. Have also experienced very mild heartburn type symptoms when before I only suffered acid reflux. Have you had anything like this. Thought maybe it was because I wasn't eating enough. Not quite the recovery I was expecting but am hopeful it will be worth it in a few weeks. How long did they give you as a recovery guide for being opened completely?
    • Posted

      I was able to swallow normally straight away which was surprising and glad of as it was one of the things I was frightened about. My progression with food is quite slow, I should be pretty back to normal at 8 weeks but I only reverted from soft sloppy 2 weeks ago. My portions are still small and like you I have that feeling that food sits just below my chest. I have felt that since my foods become more solid. It's hard to remember just how much ur stomach has changed and I often eat too quickly as I always did prior to surgery. I have lost over a stone now. Not complaining about that at all lol. My scar has healed really well, it still gets very sore though it is difficult to wear bras as they rub on the scar. I too have pain in the left side which I asked about and my gp said its where the spleen and stomach is so it makes sense I guess. I was discharged on senokot and movicol which still wasn't helping, so my gp advised fybogel due to the lack of it in my diet so that will be reviewed in a week or so. Can I ask how big your scar is? Does it bother you? Mine is about 20-25cm. Can I ask if you suffered with any breathing issues? I have been diagnosed with dysfunctional breathing following the operation. I was supposed to have had physio following the op (it's common practice for open surgery apparently) but I never, and I also caught bronchitis whilst being in hospital so it didn't help. I had heard prior to surgery a lot of people get breathing issues.. It's a slow process and more so for us with the open surgery which is a feat in itself to recover from let alone the actual fundiplication aftercare. You sound very positive though and I am sure you will recover very quickly.
    • Posted

      P.s I was off work for 6 weeks and still felt I wasn't ready but had to go back as SSP is rubbish lol.. I think recovery is varied dependant on age and health I presume. I am still very limited at doing certain things around the house etc and I'm 38 with 3 kids so it's a hard slog. Also, with regards to heartburn etc it's one thing I haven't had thank god. I have read if you over eat or over drink it can undo the fundiplication so I'm weary of this as I don't want to go through that again lol.
    • Posted

      I am just short of 8 weeks post op and have done ok. I now get some mild heartburn which I never had before and still get tired off and on. I eat ok but haven't tried red meat, pasta, rice etc. Chest tightness occasionally and some anxiety .

      Jennifer

    • Posted

      I was quite surprised about swallowing as I too had gone in with the warning that I could possibly have difficulty swallowing and unable to burp but I have managed both well. I am still putting food in a blender because I thought maybe the puree was too thick so made it a bit smoother. My scar is from just under my breasts so a bra is uncomfortable and it goes down to the start of my belly button, its quite numb feeling still. I'm actually not too bothered by the scar as I just think of myself as lucky to still be alive but prior to this hated the way my stomach was after 3 c sections. I have had difficulty taking a deep breath on and off especially after they warned it was important to prevent chest infection or phenomena. Was just told to stay on top of pain medication but any mention of physio wasn't followed up on either. I have my 6 week check up with the surgeon on 21st June so will be keeping a diary and a list of any questions or concerns to take with me. I'm very lucky I have a good family to help but have possibly done a little too much too soon also and am struggling with not being as independent as I usually am. Have even had to get help tying my shoes and getting socks on as I haven't got the ability to bend forward that I usually have lol. Hope things get better for you but its also comforting to know that it isn't as quick a recovery as I was expecting. How are you with anemia and tiredness. My iron was extremely low so am now on iron tablets and frequent blood tests to check blood clotting ability as I was still bleeding slightly inside when they let me home so ha to stop taking the fragmin injection to sort this.
    • Posted

      My bloods have been checked regularly and my iron levels have been okay, I do get very tired, to the point of exhaustion, I thought it was just an after effect of the operation and probably the lack of carbs and poor diet. I was sent back in a week after I was discharged because my gp thought I had a clot on my lung due to my shortness of breath and chest pain so was on clexane injections for over a week, blood tests showed clots but a ct scan was clear, but I have since found out that I had fluid on my lungs and also a collapsed lung (which is common with open surgery) so none of this helped with recovery really. Sounds like our scars are the same. Mine too stops at my belly button and starts in between my breast bone. I have started putting bio oil on mine as it does feel very tight at the minute. It was about 4 weeks before my numbness susided even now directly on the scar is still fairly numb but surrounding area is now ok.

      I too have had a lot of help but I'm fiercely independent so it is difficult at times, I am still unable to comfortably bend down but now doubt it will improve in a few weeks

    • Posted

      I've been told roughly 6-8 weeks but not to rush recovery. I had a barim swallow before I left hospital to check the fundoplication wasn't too tight as I couldn't manage any food the first few days, they were happy it wasn't too tight but how do they know if it isn't tight enough, am so worried its not worked completely although I haven't had to resort back to taking the tablets. I'm 36 with 3 children between 17 & 9 so they can help out but I can't imagine having to go through it all again. Do you find when you drink it gurgles' loudly in your throat and have you experienced quite a bit of wind from the bottom end, haven't had many burps.
    • Posted

      You poor thing, you sound like it has well and truly been a horrendous time and I was getting annoyed with myself today for feeling a bit down and fed up. Please keep me posted with your recovery and I will do the same xx
    • Posted

      Hi Jennifer. Have they said anything about the heartburn. I am so worried that the operation hasn't worked properly. They can test to see if they have done it too tight but what if it isn't tight enough. Its such a weird experience because you obviously can't see everything that's going on inside when you eat etc so its difficult to adapt to the changes in eating.
    • Posted

      I had the barium swallow, all was fine as far as I'm aware. I burp a lot and bottom end more so lol. Very embarrassing but I was aware it might happen.. I was able to burp within the first week post op. I don't have any issues regarding my throat although I do get a lot of noise inside my stomach after iv eaten like a loud rumbling. Kind of like how you would if you were extremely hungry. I have read up on post surgery issues as I wasn't really informed of a lot, and I'm not due for my post op surgeon appt until June 13th so it's a long wait when you have a lot of questions to ask lol. I read if you have a return of your symptoms they would presume it had loosened or come undone. They would have to do further tests, probably an endoscopy (awful, hated that test) to determine its state. I was hugely concerned as I was constantly coughing that I may have undone all the work but I was told the surgeons pre empt issues like coughing and it is done tight enough so things like that don't happen following surgery. Over time I guess these things can loosen if it did I don't think I would bother again. Not being able to be sick is also frightening isn't it! I dread the day!
    • Posted

      Lol that's what I was dreading most with all the gas coming out the bottom end and I do get an awful lot of noise inside my stomach. Had also been told that some people it is a life long fix but others do sometimes need it doing again. That is quite a wait for your post op. I'm kind of glad about the never being able to be sick but slightly concerned what happens if you get a stomach bug? 😩 do you feel if you had the choice to go back in time would you still go through with it.
    • Posted

      Hi Jen,

      Have you seen your surgeon for your follow up yet? Maybe ask about the heartburn thankfully I have not had any, prior to my surgery my heartburn so really bad and couldn't be controlled with medication. For me it has been a huge relief to not have it anymore if it came back I think I would actually cry lol. Don't forget your stomach is adjusting massively hopefully it is just a small side effect and will disappear once your stomach has adapted..

    • Posted

      Hindsight is a wonderful thing but no I would not of bothered. It is hard to say so soon after as I'm guessing things will improve hugely over time but then again it might not. Who knows with this operation. If it had gone smoothly and as it should of done then I probably wouldn't of questioned doing it again if but no one can predict these things. The stomach bug thing frightens me I will definitely be staying away from anyone with a stomach bug if I can help it lol. I was told it would come out of the other end by my gastroenterologist. And as long as u aren't sick soon after your operation you may in time be able to be sick without any issue. due to me coughing so much a few days after surgery I almost was and it was really painful, nothing came up it was like a painful dry heaving. Very strange sensation..
    • Posted

      Hopefully it will all be worth it in the long run. Am definitely not looking forward to any bugs but would rather it be the bottom end than actually being sick, that really is awful. I have found I have been unable to sneeze, it builds up and tickles my nose but then it just vanishes. Quite relieved at the moment though because I know its gonna hurt a lot.
    • Posted

      Really do hope so, would be unlucky after everything we went through for it not to work.. I did forget to mention i tried alcohol for the first time on Saturday during a friends birthday meal, It wasn't the best experience. I was very weary and drank it very slowly but after about half hour I got an awful nausea feeling and an uncomfortable pain in my stomach so I had to come home.. I didn't overeat so I know it wasn't this that caused it.
    • Posted

      Will just have to try and remain positive. Some people have said recovery can take a very long time up to a year in some cases but don't forget our recovery will be a longer road than normal due to the added complications. I'm not a big drinker but always found when I did it tended to bloat me a lot so will maybe just stick to soft non fizzy drinks for a while lol.
    • Posted

      Definitely got to try the positivity thing lol, iv found it quite hard with me being back and forth since the operation, my trust in hospitals is not what it Was. I had a few other issues during my initial stay due to
    • Posted

      Negligence on their part but as we know the Nhs is stretched to its capacity and that's another story entirely lol... Please keep in touch with your progress, and let me know how your first surgeon check up goes in June. I will do the same. Take care thanks for the chat
    • Posted

      It is difficult to keep faith, I also ended up with a damaged nerve in my foot due to someone trying to get a cannula in either in theatre or recovery that will either take a long time to heal that's if it heals at all. Was good talking to you too and good luck with everything getting back on track 😊
    • Posted

      Not yet

      I had my 6 week post op and really didn't have it then but going next week at 8 week out and will. I think too it could be food related some what because I am so ready to eat and seem to pick wring foods in my haste. Had such a hard time eating the past year or so because of the large hiatal hernia I had I am trying to make up for that I guess. Still haven't tried a lot of foods.will work up to them slow. Why are you concerned tha the operation might not have worked?

      Jennifer

    • Posted

      Purely because of now experiencing what feels like heartburn. I used to suffer from it for many years and was put on medication, it cleared up the heartburn but for the past 3 years I suffered from acid reflux whilst trying various medication. I went into the op thinking it would stop any reflux or heartburn problems so now I keep getting bits of heartburn that's what makes me worry it isn't tight enough. Don't quite understand how they can determine how tight to make it if that makes sense.
    • Posted

      how are you doing now after surgery? are you experiencing nausea or difficulty swallowing?

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