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Gastroenterology (Expert Forum)
Nissen Fundoplication: Laproscopic vs. Thoracotomy?
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
Nissen Fundoplication: Laproscopic vs. Thoracotomy?
by PJ-Holingsed, Sep 04, 1998 12:00AM
Having undergone the tests (monomatry, 24 hour pH, and upper GI) I am now faced with having surgery to correct a 7 cm hiatal hernia. Despite my pestering, my specialist conistently maintains that a 7 cm hiatal hernia cannot be repaired laproscopically (although he is a specialist in this procedure). He says the only way to really get good results for anything larger than 5 cm is through a large incision (thoracotomy).
Is there anyone in the United States who can perform this procedure laproscopically and give me good odds that it will be successful? I only want to have this done once, so I want it done right, but I don't want to undergo the thoracotomy if there is any reasonable option. I would greatly appreciate a prompt response; my surgery is scheduled for 9/22.
Thanks in advance.
PJH
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Dear PJH,
Review articles summarizing the role of laparoscopic and open surgical repairs indicate that a laparoscopic procedure is not for everyone. Obese patients, those with fixed hernieas. and those with HERNIAS GREATER THAN 5 cm in size should have an open procedure. Having written this, I also recognize that every case is unique and that these exclusion criteria are not absolute. I suggest thatr you ask your surgeon if he kbnows of any colleagues that would do an open procedure with a large hernia.
This information is presented for educational purposes only. Always consult your personal physician for specific medical questions.
HFHSM.D.-rf
*keywords: esophgeal reflux, hiatal hernia, surgery
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