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Cerysan
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Quote Cerysan Replybullet Topic: problems after surgery
    Posted: 29áJaná2018 at 12:18pm
I want to know if anyone has ever had nissen fundoplication procedure more than twice? I had first op about 9 years ago and it was successful. It failed after several years and I was put back on medication 40mgs eso-omeprazole and Ranitidine twice a day but it still did not completely resolve symptoms and this is when I got diagnosis of Barretts Oesophagus. I had moved to a different part of the country by then and asked to be referred back to my origionel surgeon but was refused so went ahead with a local surgeon. I wish I had not done so. I was discharged next day but within days I was back in theatre with an abscess and infection. Ended up in hospital for 3 weeks where things just got worse. I wont go into detail about that at moment but outcome is I am worse off than before. I am back on medication plus Gaviscon Advance and Metoclopramide as well. I have spontaneous vomiting, diaerrhoea, severe wind and abdo pain, am always bloated and discomfort in my chest. Eventually got response from hospital and they say I have scar tissue to lung, adhesions to bowel and there is nothing they can do except give analgesia for stomach pain. I dont believe that nothing can be done for the reflux and vomiting at least. I know they have done surgery for 3rd time in USA but do not know about here. Would love to hear from someone who could shed light on this as I cannot face the thought of spending the rest of my life like this.
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steveb8189
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Quote steveb8189 Replybullet Posted: 29áJaná2018 at 3:36pm
Hi Cerysan
Sorry to hear about your problems, it sounds like you've been through quite a bit.

I will wait for someone with more experience to comment on the 3rd surgery route but I am suprised to hear about your other issues from a nissen. I presume you ended up with open surgery rather than keyhole?
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chrisrob
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Quote chrisrob Replybullet Posted: 29áJaná2018 at 3:42pm
Hi Cerysan and welcome to the forum.

Yes. It is possible to repeat a Nissen again - and on NHS.
It does help to find a good surgeon. I don't know where in UK you are but I do believe in Southampton we have the best.

I had my first fundo (an ordinary Laparoscopic Nissen ten years ago - best thing I ever did. However, following 5 hours violent retching with norovirus it cam loose. My repair used a Collis-Nissen revision. This is more permanent by effectively lengthening the oesophagus to provide a better hold for the wrap.
Collis:
Nissen:

I have previously discussed possibilities of a third fundo with my surgeon on someone else's behalf. He said he'd be happy to do a third one but that he would probably do a Collis-Nissen.

It is more major surgery than ordinary Nissen. Whereas with my first op I was out of hospital the next day, they chose to keep me in a second day for my revision - and I had more tubes attached.
(You may read my blog of that here if you wish.)

It did take longer to get back to anything like normal. I was full very quickly (as after ordinary Nissen) but if I ate too much, I became hypoglycaemic and passed out suddenly on 3 occasions. However, within 6 months, I cycled over the Andes.

Th only concern I may raise about you receiving further surgery are your adhesions. My wife has adhesions following major abdominal surgery and a near fatal bleed. Surgeons will not operate further on her - though that's probably due to her prevalence to bleed rather than the adhesions. It is something you will need to speak to a surgeon about.

All the best
Chris
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Cerysan
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Quote Cerysan Replybullet Posted: 29áJaná2018 at 4:19pm
Thank you so much for your replies. Firstly steveb it was keyhole for the second operation as well but involved 2 very painful abdominal drains which kept me from breathing properly and I ended up with fluid on both lungs and it is the subsequent chest drain that has left the scarring. I thought I was gping to die in there. Chrisbob thank you for your info (I will certainly look at your blog) Big problem is as you say finding a competent surgeon which. I was refused a referral elsewhere when I first asked, although they might consider it now as they know they have messed up. They have said they will do the 24hr ph and manometry studies here to see what more is going on. I dont want them again as they will only confirm what I already know, but if I do manage to get referral to somewhere else would it be better for them to do these studies or would they take the word from another hospital. Am not sure what to do at the moment. I realise it is going to be open surgery this time and will depend on what they find inside as to what can be done. Im horrified at the thought of more surgery but know I cannot carry on like this
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chrisrob
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Quote chrisrob Replybullet Posted: 29áJaná2018 at 5:18pm
If the testa are correctly carried out and recorded, they'll probably be acceptable to a different surgeon.
And it should probably still be possible to carry out another revision by keyhole surgery.
One of the surgeons at Southampton invented laparoscopic Ivor Lewis oesophagectomy (to remove cancerous oesophagus). When he wrote a paper on it, it was rejected by his surgical journal as the reviewers said it wasn't possible. He then demonstrated it at a conference and it had to be accepted. He now teaches others the technique.
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