What can be done to correct problems with my 4th Nissen Fundoplication & Paraesophageal Hernias?

[SurgeryVet]

Hi! I am a 48 yr old female & have had 4 Nissen Fundoplications with paraesophageal hernia repairs, the first in 1997 just after my father passed away from esophageal cancer. I had the 1st one in a small community hospital by laporscope.  The day after my surgery, I knew something was horribly wrong. It was written off to "post surgical" symptoms. I found out later it had been botched 100% and almost killed me. My primary care doctor got me referred to a large university facility several hrs away and I had my second fundoplication by laparoscope 4 months after the 1st. That surgeon is world reknown for these surgeries & I did really well for another 6-8 months and then started to have problems again. I was referred back to the same university surgeon and he scheduled my third procedure in 1998... this time it was an open procedure and I was in the hospital 12 days. I did well for 10 yrs.

In Sept 2008, I was admitted to my local hospital and found out I needed another Nissen Fundoplication with another  large paraesophageal hernia repair. I spent most of December & January in my local hospital being treated for symptoms - my surgery  was too complicated to be done at the local hospital. Due to problems with my HMO, it took almost 4 mos before I was finally referred to a different university hospital, 4 hrs away from my home.  

I just had my fourth Nissen and hernia repair in an open procedure by a great team of doctors in March 2009. They also cut the pylorus. I was doing extremely well initially and only spent 9 days in the hospital, but am now having problems. An upper GI shows a section of the wrap is tight, so I am having trouble swallowing and eating. I also have pain (sometimes extreme) while eating and even feel choked just drinking water. My surgeon is trying hard to help.  I am now scheduled for an EGD to "stretch" the wrap. I have started to advance my diet as recommended but everytime I eat anything but yogurt, I have diarreah, sometimes while sleeping and it doesn't even wake me. I am very concerned about "dumping syndrome" due to the pylorus being cut.  I also worry that the vagal nerve(s) may have been nicked or damaged during the surgery and may be contributing to the problems.

I have lost over 40 lbs since January. I still have a G-J feeding tube in my stomach (put in during sugery in case it was needed during the healing process). I have started to use it, since I continue to lose weight & need adequate nutrition. A fifth procedure, if needed, will likely cause the removal of my stomach permanently. Does it sound like a possible problem with the surgery itself? What else can be done to help resolve the problems? Any advice will be greatly appreciated. Thank you.

Has anyone else out there had this many problems? Please advise.