NISSEN FUNDOPLICATION/HIATAL HERNIA

NISSEN FUNDOPLICATION/HIATAL HERNIA

I had the following procedures done - Laparoscopic Nissen Fundoplication; Incision Hiatal Hernia and Keloid removal; after severe complications with impaired movement of food through my esophagus, bloating, severe coughing, asthma-like symptoms, Laryngitis, Tracheitis, Allergic Rhinitis, Pharyngitis, etc. (reflux-induced airway problems)

With my Variegate Porphyria I can’t tolerate the use of lifelong GERD (gastro esophageal reflux disease) medications; so a Nissen fundoplication was my fate.

Nissen Fundoplication is the most common fundoplication and involves wrapping a portion of the stomach completely (360º) around the base of the esophagus; thereby significantly increasing lower esophageal sphincter (LES) muscle pressure. That is strengthening LES muscle and allowing LES to close properly and prevents contents of the stomach from backing up into the esophagus (reflux)

My fundoplication was performed laparascopically which made the recovery time shorter and there is less scarring, especially with me forming KELOID scarring.

However with my Hiatal Hernia open surgery was required which eventually lengthened my stay in hospital to six days in high care.

The laparascopic incisions involved several tiny incisions (about 1 centimeter in length) in my abdomen with a laparoscope (a thin, lighted tube with a tiny video camera attached to it) inserted in one of them. Instruments that hold open and move the parts of the body involved in the surgery were also placed in the remaining incisions, so that my surgeon could wrap the fundus (the uppermost portion) of my stomach in a circle, completely around the lower part of my esophagus. The wrapped portion of my stomach is kept in place with stitches. This wrapped portion should strengthen my lower esophagus, thus preventing reflux by increasing pressure on my LES muscles so they do not relax and allow stomach contents to wash back into my esophagus like previously.
I have six 1cm incisions altogether.

My Hiatal Hernia (protrusion of the stomach into my chest through a hole in my diaphragm) was repaired with an open incision.

I had an excellent surgeon who is very experienced in fundoplications. My operation took 2 ½ hours.

I followed a liquid diet for two weeks after the operation; which included any food that has been pureed. Soft porridge like maltabella, soup, mashed potatoes, yoghurt, scrambled eggs and milk was on my daily menu.

However when I slowly started on a bit of solid food, I found it difficult to swallow and it caused severe gas/bloating.
So I am battling with pain/difficulty swallowing (Dysphagia). My Dr said it should improve within 3 months and it may be related to difficulty determining the looseness of the wrap with the laparoscope.

So I am back on baby food. No meat on the menu and I have to chew my food forever… Anything I eat has to travel smoothly through my esophagus into my stomach. So solid food is still not my cup of tea after six weeks, especially after a piece of food got stuck in my esophagus. What helped was I tried to wash it into my stomach by slowly drinking luke-warm milk. Luckily it didn’t remain lodged.

I also encountered ‘feeling full’ after eating small amounts of food, but this should also disappear after 3 months. Not that I mind, that is good to keep the weight down.

I am not taking any reflux medications and only use pain tablets when necessary.

I didn’t have any problems with my stitches, because they were placed just below the surface of the incision and were absorbed by my body and no ‘stitch removal’ was required. The radiotherapy I had was a plus; thus Keloid (scar tissue) forming was not an issue.

I had bad post-operative symptoms, such as gas-bloating syndrome, which is very painful and uncomfortable! But it should diminish over time according to my Dr.

I don’t have the ability to belch or vomit to relieve bloating or nausea and I just hope that it may not be long-lasting, because if I should have a Porphyria attack which involves serious uncontrolled vomiting, I don’t know how I’ll cope…

The worst scenario could be that my GERD symptoms and Hiatal Hernia may also recur…

It is six weeks now and I am walking, allowed to drive and going up and down the staircase at my house. Strenuous exercises that could affect my abdomen like sit-ups or using weights are still out…

This operation was a bad one for me and I truly hope that I won’t require any further/additional surgery