Anterior partial fundoplication, preferred????

Blasterboy · 03-01-2005, 02:31 PM

Hi, I've just seen a consultant surgeon about my GERD/GORD and he wants to perform an Anterior partial fundoplication (180% partial wrap) instead of the full Nissan wrap.

It sounds like a much better alternative and apparently has much less instances of post operative gas bloating, inability to vomit and diarria etc. He also reckons that it's pretty much as effective as the Nissan. I'm wondering if anyone out there has an opinion on this operation over the Nissan.

He also only wants to perform an Endoscopy beforehand and will only perform an Manometry if the Endoscopy isn't conclusive, is he cutting corners already???????

mathis000 · 03-16-2005, 11:58 PM

I just had a Full Lap Nissen on the 2nd of March after many tests, and years of having acid reflux. I think that the partial wrap will work depending on how bad your acid is, and the strength of the sphincter at the top of your stomach. I have had the following tests, and doc said that I've got the worse Reflux than anyone he's ever met.

Manometry - all upper muscles read normal, bottom of espohagus was around 7-10% *Normal is 30-35%
24 hr P.H. test - Average acid readings were 7 points? away form the norm
Have had 3 endoscopies, having ulcers found on two of them.
Had also done the Barium test (not sure what it's called)
And another test that I had to swallow something kind of like Alka-Selzer on Steroids without being able to burp.

ALL of these tests were positive for Acid REflux/GERD.

I was also on an extremely aggressive medicine plan..

300 mg Ranitidine (Zantac) Twice a Day
40 MG of prilosec twice a day

Doc said that since my acid was so bad that the Full Wrap was right for me. The surgeon/doc wouldnt be cutting corners because he/she's going to be in there anyways. If i could have had the partial wrap and still have the effectiveness as the full then that's what he would have recommended. So basically if the surgeon/gi doc says that the partial will work, then most likely it will. As long as there aren't any complications.

Blasterboy · 03-17-2005, 06:25 AM

Hi Mathis and thanks for your feedback. How are you getting on with the post op recovery? Was it painful for the 1st few days and are you able to eat much yet?

I'm probably not as bad as what you were, which is another reason for favouring the partial. I'm been 90% controlled with 60mg Omoprazole a day...

I had my endoscopy 2 days ago and the Surgeon does now want to perform the Manometry and PH test as the endo' showed no signs of GERD. Apparently this is quite normal, especially given that the mediacation is giving 90% control, it's saving me from much of the damage that you've suffered previously it seems.

mathis000 · 03-17-2005, 07:30 PM

Went in today for my F/U appointment, and got the okay to start eating regular food. The surgery itself wasn't really that painful. What was painful for me was the Gas Bubbles that I had from them blowing up my stomach. But those went a way after 3 or 4 days. Now I've got a lot of bloating/belching, but doc says that's a common occurence with this surgery. The ph and manometry will tell the surgeon whether or not you need the surgery. Good luck with those! You have to stop all of your medication for those tests! Not fun....but worth it!

Blasterboy · 03-18-2005, 05:49 AM

That's good that you can belch already. Many Nissan-ees can't ever do that easily again. Did you need strong pain relief for the post op pain?