Fundoplication Slip

[RT48]

In November 2005 I had Nissen performed and everything went well.  I have been symptom free for a while until last year, then the heartburn and reflux slowly started creeping in.  Things came to a head in December when I vomitted and again in January.  I had an endoscopy performed and the GI doctor saw where the wrap had slipped and a hiatus hernia had developed.  I know these types of hernias are common.  After having a HIDA scan and a RUQ ultrasound performed, everything came back clean on the gallbladder.  He referred me to the surgeon that performed the original Nissen and I went to him today (with pictures from the endoscopy showing where the wrap slipped).  After being in my room for approximately 2 minutes, the surgeon left the room spouting off that he wanted an Upper GI performed and left me even more confused than when I arrived.  If the HIDA scan and the RUQ ultrasound ruled out the gallbladder, and the endoscopy showed the fundoplication slip, then why am I having to have more tests done?  If I'm not supposed to be vomitting, regurgitating, and having heartburn, then wouldn't the obvious answer be that the wrap has slipped (especially if a camera placed down my throat inside of my stomach showed the slip)?  I am so irritated because these are the same exact symptoms that I had prior to the surgery, the endoscopy has shown where the wrap has slipped, and yet I am still having to have more test done...WHY???

[RT48]

Hopefully the test will come back negative and they will be able to get you back to health without surgery.  I know that must be nerve-wracking.  Keep us informed.  I saw the surgeon yesterday for the follow up to the Barium swallow.  They found a hiatal hernia and it has slipped so far that it pulled the NF wrap down causing the chest pains and heartburn. I am scheduled for surgery Thursday so that he can pull the stomach back down and redo the wrap.  He's unsure of how big the hernia is and said that he may also have to repair the diaphram if the stomach has slid up there enough.  To complicate matters, since this will be the second NF surgery he will have to work around scar tissue. He wants to do it laproscopically again, but he said it is more difficult the second time around because of the scar tissue. So while I'm under he will have my gastro doctor in there with a scope down my esophogus so that he can work around the scar tissue to avoid having to actually do an open NF procedure.

[Flycaster305]

I'm so sorry this happened, and understand the angst of anticipation, especially when the surgeon is confusing you.  I'm very interested in what the surgeon says, I hope you will return to this site with whatever information you receive. The NF recovery is not a picnic, so would also be nervous, once was enough for me.   I have heart issues, and just did a test that is leading to another invasive test that might lead to bypass surgery, so know the difficulty of waiting these things out.  Do keep this board informed, and best wishes.

[RT48]

Thanks for the response Flycaster. That is my intitial thought on it as well and it is frustrating beyond all belief that they want to keep running tests when the endoscopy pictures showed the wrap having slipped.  I don't know what I'm looking at, but the GI doctor pulled up my pictures and showed me parts of my stomach that shouldn't be visible after an NF, so he referred me to the surgeon.  Went and did my Upper GI and esophagram this morning and don't go back to the surgeon until next Thursday.  It's the anticipation that makes this so hard

[Flycaster305]

The fact that you vomitted suggests strongly that the NF procedure ruptured.  I'd check for another surgeon in the area where you live who has done this procedure many times, and get a second opinion.  Endoscopy is the gold standard.  Keep up informed.