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Sm12
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Quote Sm12 Replybullet Topic: Advice on fundoplication please
    Posted: 16†Feb†2020 at 7:27am
Hi Iím due for op April was all set up for having an anterior wrap done as motility is 40% good 30% poor and 30% none with surgeon as he does the Dor anterior 180 80% of the time because he says heís very happy with the results he gets and it has similar results and the risk of dysphagia isnít worth it,
I saw another surgeon today a woman who had become a consultant in last year or so she said sheíd done about 50 ops and she said she would do a floppy nissen and if any swallowing problems a dilation then maybe a 270 toupet if needed. This has really thrown me as the research Iíve done tallyís with what she says but this Iíve read is a skilled op that needs experience, Help!! Heads shot on making a decision, to throw in the research Iíve done in some cases has the toupet and 180 anterior similar in reflux control. so I need to decide to go with the more experience but chance of reflux returning but less side effects or the less experience, more chance of control but higher chance of issues post op. Any advice would be very appreciated thanks.
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chrisrob
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Quote chrisrob Replybullet Posted: 16†Feb†2020 at 1:10pm
Sorry, I can't advise one way or the other.
I realise a traditional Nissen Fundoplication is not suitable for someone with poor motility and a Toupet or Dor may often be provided instead.
I don't know sufficient about the outcomes of a floppy Nissen to comment but how effective is it at reducing reflux if it remains loose?

At the end of the day, it is up to the surgeons to advise you on what they perceive as the best cause of action.

Whatever you opt for, I do hope it works for you.
I have been the recipient of two fundoplications.
The first, 12 years ago, was a traditional Laparoscopic Nissen which worked well until it failed five years later following 5 hours of violent retching from norovirus.
Then 6 years ago, I had it repaired with a Collis-Nissen revision which is holding up fine.

There is a chapter on fundoplication in the Down With Acid encyclopaedia.
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Sm12
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Quote Sm12 Replybullet Posted: 17†Feb†2020 at 11:18am
Thanks for reply the problem Iíve got is I need to decide myself apparently all surgeons have there own way of doing this surgery.
What reflux gone but donít want dysphagia afterwards so am stuck on choice.
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