I have copied and pasted my response to FloatyGimpy’s threada week or so ago and added some detail. I’m a little reluctant because I don’t wish to alarm you needlessly and I talk about it so much already that I always fear that the dopers are way bored of it. However, here is the tale:
I suffered GERD all my adult life. I would wake up choking on my vomit and then I would hack and cough and eventually empty my stomach. (It would have been easier if I just emptied my stomach each night before going to bed, but made me feel like I had an eating disorder.)
In 2003 I was operated on for a hiatal hernia. They performed a fundoplication.
In my case, the esophagus was too short. Since they did not spot this, they did not operate correctly. The operation made things much worse. In the first two days the sutures burst and they operated again.
After I was released (24 days in ICU) the hernia came back almost immediately and even emptying my stomach would not permit me to sleep (I would wake up choking on my stomach contents.)
John’s Hopkins wanted to take out my esophagus and stretch my stomach up to the top of the throat, forming a faux esophagus. That might have worked, but it sounded nuts to me. I now wonder what my path would have been like had I allowed it.
Hershey didn’t *refuse *to operate, but they did every thing they could to talk me out of it. I didn’t want to be on the table with someone whose heart wasn’t in it.
Finally Geisinger Medical operated in 2004 and I was good for about a year.
In May 2005 my stomach just stopped working. Nothing would go down. I’d fight to put a quart of gatorade in me to try to stay hydrated. I was actually convinced that I was probably going to die. I was losing a lb a day and in June 2005 my stomach perforated (tore itself open.) (I begged God to take me home, it hurt so bad!)
As best as I remember the explanation (remember throughout this tale that a lot of the time things were explained to me when I was on heavy pain meds. It would not be far fetched to find that my technical details are inaccurate - but I do tend to write everything down, even when on pain meds): They take part of the stomach and wrap it around itself to prevent the GERD. In my case, part of the stomach had worked its way up through the wrap and the wrap was strangling it, eventually so much so it caused it to pop.
The result was emergency surgery that lasted 10 1/2 hours and I came close to passing-on more than once.
The stomach couldn’t be saved, and they took the stomach out of the pipeline and now my esophagus is attached directly to the small intestine. It isn’t too bad - I can’t eat regular meals and instead have to graze all day - but at least the GERD is gone. It is kinda fun when I have an upper GI, because it always freaks out the techs. (Actually, after the first few times I started to warn them.)
After that, I had several hernia operations and then finally, in 2006, after loops of small and large intestine found their way up into my chest cavity, they performed my last operation.
It makes me a little sad that, no matter how much weight I lose, I’ll always have a big bulge right under my rib cage where the mesh holds in my guts (it looks like I have a very high riding beer belly) but it better than the alternative. I have a neat little titanium bolt in the V of my rib cage where they tied off the mesh and I have an ugly off-center faux belly button that they made because they cut my real one out. (It is off to the right and I kind of think it would look - well, no worse - if they had just left me without any belly button.)
One thing: be sure ask them about Barrett’s.
jjimm, this is an ugly tale, but note that my case is uncommon. Many thousands of successful fundoplications are done every year. This is a known procedure and very common.
Besides my esophagus being too short, I believe that my first surgeon was not competent. Be sure to note that I cannot prove that. I did hear (from a nurse who worked at the hospital - I met her at a bar) that he was forced to retire due to faking some of his certifications and a higher-than-acceptable mal-practice suit rate. (Not the most reliable of sources, as we were both a little drunk.)
In my experience, this too is rare - I have had a great many great doctors. (And even more wonderful wonderful nurses!) Even had he been competent, my current surgeon tells me that my problems are rare enough that it would be easy to overlook unless you had experience with such things.
::shrug:: Competent or not, he did miss it and bad things did happen - so all I can do is live with it.
My current surgeon, the one who saved my life, had suggested Bariatric surgery, rather than re-do the fundoplication. Although I needed to lose weight, I was against that, even though he was 100% convinced that it would fix the problem. As I said above, I often wonder how my life would be different had I allowed that.
That’s my tale - but I’ll end with this: from experience, laproscopic surgery is just about as gentle as a surgery can be. I expect your brother will be up and around the next day - really. And I also expect his life will be better for the surgery.