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.
14 likes, 161 replies
Maboyali julieangel
Posted
mag2 Maboyali
Posted
paul90174 julieangel
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Barretts paul90174
Posted
Throat irritation and cough point to reflux rather than acid as being your main concern. Medicatin is good for reducing acid but may not help with reflux other than making it less corrosive.
The vast majority of people having Nissen are entirely satisfied - though they may not wrie about it as much as the few who have a problem.
From the Down with Acid book: 'A study published in Surgical Endoscopy in 2014 reviewed the durability of Laparoscopic Fundoplication over 20 years and concluded, "Long-term results from the early experience with LF are excellent with 94 % of patients reporting only occasional or fewer reflux symptoms at 20-year follow-up.'
There are other procedures (which yu may find on the www DownWithAcid org uk site in the chapters on Reflux Reduction Techniques) but Laparoscopic Nissen Fundolication is the gold standard.
The Esophyx (Transoral Incisionless Fundoplication) may sound appealing but doesn't have anything like the success rate.
From Down With Acid:
An article in World Journal of Surgery in 2008, "Anti-reflux Transoral Incisionless Fundoplication using EsophyX: 12-month results of a Prospective Multicenter study," written by surgeons employed by Endogastric solutions, concluded, "12-month results showed that EsophyX-TIF was safe and effective in improving quality of life and for reducing symptoms."
This helped the device get FDA approval for use in the US.
However, the paper also stated, "Global assessment revealed that 56% of patients were “cured” of their GERD based on the clinically significant reduction of their heartburn and complete cessation off PPIs."
nezra paul90174
Posted
Hi paul,
I had my surgery (Nissan fundilplication) full wrap in March. For me it has been life changing, not necessarily in a good way either. In hindsight I would not have bothered. I think unless your life is affected massively by your symptoms now, don't bother. this is just my opinion, and maybe because I have had a bad experience I am biased. I am just saying not to think about it lightly if surgery becomes an option
elizabeth52591 julieangel
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jenlyn24 elizabeth52591
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I just wanted to let you know,that I had the 360 nissen fundoplication surgery 8 weeks ago and,I have lost,weight and still trying to balance it all out. I had a large sliding hiatal hernia that was repaired along with wrapping my stomach around my esophagus. So far pretty good,still trying to reintroduce foods and get back to normal. I actually didn't have heartburn, gerd or chest pains before but now I do get a very little but tolerable. Hope all goes well and I will answer any other questions of I can.
Jennifer
mag2 elizabeth52591
Posted
My op is on June 8th, I'm expecting to loose a bit of weight while recovering, I'm not overweight but no harm in loosing a bit for the summer, I'm sure once I'm back eating properly again the weight will go back on..
I am having the op to reduce symptoms, chest pain, constant phlegm, burping, nausea when I eat too much, etc .
I'm 46 and had these symptoms most of my life, I'm on 40mg of Nexium and ranitadine and gaviscon when needed ( most days)
I do hope after the op I can be rid of all this and enjoy food like never before.
I'm not sure how big my hiatus hernia is. I've got my pre op assessment tomorrow morning. Good luck with your op.
mag2 julieangel
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Hi Julie and all in this discussion,
I had my op 12 weeks ago now, I'm doing OK I think, the discomfort from op and scar tissue is easing off a bit now, on the odd day I have a bit of nausea, sometimes it can be just that I'm hungry, most days for my dinner I have a small bowl of pasta with grated cheese frozen mix veg and glug of olive oil it's really all I can be bothered to eat, bran flakes in the morning and spaced through the day small cheese sandwich, cuppa soup, granola bar,small smoothie, and maybe a bowl of flakes before bed.
I went out for dinner Sunday and had gammon, it was massive but I managed a third of it maybe less and some chips, that was it for the day I was stuffed.
I find I have a tiny bit of phlegm still nowhere near the scale I had it before the op and get bloated feeling very easy.
Lots of wind both ends.
It would be great to hear how everyone else is getting on further into recovery to me, I do hope you all are doing well :-)
Margaret x
jennifer24404 mag2
Posted
Hello Margaret, good to read your comments. I had my op on April 15 so am almost 5 months on. Recovery from it has been slow but ok. Still trying to deal with changes in bowel movement. Sometimes go for three days with nothing. Like you meals are different, yes pasta is good. I find that I have to make myself eat something cos don't feel hungry. Fill up real fast when I do eat so 6 small meals a day seems to be the way forward. It is so good to feel better though, no more reflux and able to breathe better is fantastic. Wishing you well. Jenniferx
mag2 jennifer24404
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Thank you Jennifer,
I went shopping today and looking at what I bought for myself to eat compared with what I bought my partner it's ridiculous, I filled the freezer with food for her ( she veggie) and barely anything for myself, then I will cook her lovely meals and me well I just stick with my pasta for now, hopefully by Christmas I will be eating a bit more adventurously..
What I do enjoy now very much is having a bowl of flakes before bed and laying down properly in bed after and no reflux of the flakes..
My bowels are back to how they were pre op, main visit just after breakfast and maybe 1 more in the day, no diarrhoea at all :-)
Margaret
nicole95189 julieangel
Posted
So glad I found this post. I had the full wrap and repair to my HH 12 days ago. I haven't been able to keep any food down not even water. I wish I knew how horrible the outcome would haven been before I got the surgery. Mine was done by a thoracic surgeon who was recommended by my gastroenterologist. After the surgery I spent 5 days in the hospital. The first three my diet was very strict, one small cup of water a day! I did have an IV thank goodness. The last day I was advanced to full fluids but unfortunately I'm lactose intolerant and gluten intolerant so I have very few goods I can actually eat. A few days after I was released I wasn't able to keep any food down, I hiccuped constantly and alerted the surgeon his receptionist not even him put my back on full warm fluid and since then it's only gotten worse. I constantly regurgitate white foam and mucus since the only thing I can semi keep down is room temp water. I've lost 12lbs and I'm not overweight so i am highly concerned. I went to urgent care and the doctor alerted me to get in contact with my surgeon whom I'm still waiting for a call back 3 days ago from when I previously called. I have a sever burning in my throat that's constant and I'm unable to burp. I keep getting sever chest pains Everytime I take a sip of water that turns into not being able to breath causing me to regurgitate just to catch my breath. I recent found out that if you have achalasia this surgery is not recommended however my surgeon and gastroenterologist knew from my pH manometry and 24hr manometry that I have achalasia so I don't see why I wasn't informed of this before the surgery. It just seemed to make it worse plus the sever burning in my throat. I honestly feel like my surgery was a failed one or the warp slipped or something b.c the only pain and discomfort isn't from the incision but from all my postopt side effects. I'm still on both my ppis and now added sucrafate and zofran. I was also informed that I have an enlarged floppy liver and spleen. However the surgeon has no idea why I have this abnormalities. He stated to alert my gastroenterologist. For reference I'm 5'2" and 112lbs.
mag2 nicole95189
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Hi Nicole,
I'm sorry to hear that you are having such a bad time after your op, maybe they shouldn't have done a full 360 wrap for you as you already had problems swallowing . My manomatory test showed my swallow was fine and I only had a 270 wrap done, I've I was out of hospital the next day and could manage to drink no problems and small amounts of sloppy food, I kept everything down, I did have some bouts of nausea but the cyclizine anti sickness tablets helped.
Best wishes to you and I hope you are feeling better very soon.
Margaret x
nicole95189 mag2
Posted
Hi Margaret,
I wish I knew there were different wraps before I had the surgery, I was only told of the one by my surgeon.
I'm glad to hear the surgery went well for you, thank you for your kind words. I hope you have a speedy recovery.
Best wishes to you as well.
Thank you
Nicole
kay_from_ok nicole95189
Posted
Nicole, we must have had the same surgeon. Mine actually told his nurse to tel me to stop bothering him and go see my gastro doctor. I have regretted the surgery and it's been over 18 months. My wrap has slipped and the HH is back and a new surgeon does not want to do surgery to repair the slipped wrap because there is too much scar tissue left behind. So now what. I tend to vomit daily and never go any place without a "barf bag" or know how fast I can get to the restroom to throw up. I had Botox injected into the sphincter muscle and that has helped some. I often go 3-5 days without vomiting, but still have feelings it is going to come, but at least a couple of days vomit free is great. I havel ost over 30 pounds (i was aittle over weight) at 5'2" I weighted 130 and now weight under 100. Stillhave trouble with cold liquids and tend to avoid them most of the time. Small amounts of food still and only able to sip water, would love to take a large drink and swallow without pain. Oh well! I wish you luck and am glad I am not the only one who is not happy with the surgery. I would not recommend it at all.