Background/purpose: In neurologically impaired children,
The Nissen fundoplication is the most common anti-reflux operation performed. Gas bloat and inability to vomit after repair may be severe, but infrequently require reoperation; in contrast, other complications can be very debilitating or life-threatening.
The most common complications are difficulty swallowing, abdominal bloating, diarrhea, and nausea. Most patients can't belch as well as they could before surgery, although the inability to belch is distinctly uncommon. About 25% of patients can't vomit after surgery.
Symptoms associated with slipped Nissen fundoplication range from mild chest discomfort to severe heartburn and inability to swallow food. Shortness of breath may result from a slipped Nissen fundoplication, aka recurrent hiatal hernia.
You should be able to progress to a soft-normal diet 4 – 6 weeks after surgery.
This operation is designed to stop vomiting and reflux but it can also stop normal 'burping'. This means that air can get trapped in the stomach and colicky pain may occur.
Nissen fundoplication
Although this works well to control reflux, it can also cause complications such as bloating and swallowing difficulties, called dysphagia. In some people, these complications persist after surgery.
The primary risk of Nissen fundoplication surgery is that symptom relief does not always last. Some patients need another surgery after two to three years.
Dumping syndrome is a rare presentation after Nissen fundoplication and is predominantly reported in the pediatric population. Many of these reports suggest that there may be an association with vagal nerve damage, although the exact etiology is unclear.
This operation can also come undone over time in about 5 to 10% of cases, leading to a return of symptoms. If these options do not relieve symptoms, surgery may be needed. Therefore, the success of Nissen fundoplication requires assistance between the gastroenterologist and surgeon to avoid undesirable conditions.
After you've had surgery, you may feel sick to your stomach (nauseated) or you may vomit. Sometimes anesthesia can make you feel sick. It's a common side effect and often doesn't last long. Pain also can make you feel sick or vomit.
PONV can lead to complications. These include dehydration, discomfort, pain, and problems with the incision.
Nausea and vomiting can be a common side effect of anesthesia or pain medicine. Nausea and vomiting after surgery can last up to 48 hours. However, if nausea or vomiting persists for more than 24 hours or you throw up more than two times, please call your doctor. There is medication that can help.
Persistent or recurrent symptoms of reflux and/or persistent postoperative dysphagia are the most common indicators of fundoplication failure (13). Such failures are due to a fundoplication wrap that is too tight, too loose, disrupted, or incorrectly positioned or that has migrated into the chest (1,2,8,13–17).
Re-operative intervention for failed fundoplication can be performed through a minimally invasive approach with good results (14,17-20).
You can do light activity within a couple of days of surgery. You need to avoid heavy activity for 6 weeks. You can drive again when you can confidently make an emergency stop. However, it is a good idea to check with your insurance company when you are covered to drive again.
Because the surgery makes your stomach a little smaller, you may get full more quickly when you eat. In 2 to 3 months, the stomach adjusts. You will be able to eat your usual amounts of food.
As you heal from your hernia surgery, it will be best to say no to foods that are hard to digest (such as red meat), and foods that can cause acid reflux, such as caffeine, chocolate, and spicy foods.
Post-fundoplication dyspepsia is a common complication of gastric fundoplication surgeries. This can be attributable to the loss of fundal relaxation, decreased gastric accommodation, and/or alterations in gastric motility and sensitivity following fundoplication.
We demonstrated a great response rate of 77.1%, with a mean follow-up of 3.7 years. In this study, we found excellent quality of life after Nissen fundoplication. Nissen fundoplication has been proven effective in reducing GERD and preventing recurrence, even at the long-term follow-up.
The most common procedure will be a redo laparoscopic Nissen fundoplication. The procedure may need to be done via a laparotomy (an incision in the abdomen) in selected patients. If multiple surgeries have failed, an esophagectomy (esophageal replacement) may be required.
Laparoscopic Nissen fundoplication is one of the most common antireflux procedures. Unlike antireflux medications, laparoscopic Nissen fundoplication offers permanent relief for gastroesophageal reflux disease (GERD).
Also known as a Laparoscopic Nissen Fundoplication, this procedure will eliminate your acid reflux symptoms for good. However, it is major surgery and it has its own risks associated with it.
Hiatal hernias recur after surgery 15% to 50% of the time, says Miguel Burch, MD, chief of Minimally Invasive and GI Surgery at Cedars-Sinai.
Nissen fundoplication or wrap is constructed by suturing stomach to stomach. Full thickness bites are taken on both sides of the stomach to create a durable wrap. Toupet fundoplication, on the other hand, is constructed by suturing stomach to esophagus.