I consider myself very fortunate and blessed by God to have found an excellent laparoscopic surgeon who is well qualified in the field of bariatrics. In 1998, my surgeon performed a “Classic” Nissen Fundoplication. Through this procedure he created a robust “heavy-duty” sphincter valve to encompass and “support” my weakened LES muscle that was allowing acid to reflux and burn my esophagus.
For five months after my surgery, I suffered annoying degrees of dysphagia (including two trips to the Emergency Room to “clear” soft food that jammed my esophagus shut) and occasional severe chest muscle spasms that mimicked a heart attack whenever I allowed my stomach to completely empty itself. But, the “pain” was “worth it” because I have been completely “free” of reflux and heartburn for fifteen years. And, I have been able to avoid potentially dangerous and very expensive regimens of PPI’s.
My current status: I can belch. And, I can vomit if I get stomach or food poisoning; but I cannot vomit from nausea caused by the flu. I can retch or cough or lift heavy weights or exercise strenuously at any time without causing damage to my fundoplication wrap. The only consideration - for the rest of my life, I must chew my food thoroughly and swallow slowly, and finish my meal with a drink. I can eat anything my heart desires (including doughy breads and bagels), at any time of the day, without heart burn or reflux. Frankly, my stomach works better post-surgery, than it worked before. Now, I can drink tomato juice or orange juice without any burning sensation.
The Nissen Fundoplication (as performed by Dr. Rudolf Nissen in the 1950’s) has gone through many “designer modifications” by the world community of surgeons in order to “appease” a large portion of the general public. And, sadly, not all of these modifications represent better long term results for the patients. My procedure was the “Classic Nissen Fundoplication.” Today, it is rare to find a surgeon who will perform this same “original” Nissen Fundoplication procedure with a 5 centimeter wrap.
Most surgeons today prefer the modified “short floppy” Nissen Fundoplication procedure where the wrap is shortened from the original length of 5 centimeters, down to a much shorter length of 2 centimeters. Additionally, the short gastric vessels connecting the stomach to the spleen are “taken down” - mobilizing the fundus - making it “floppy” (without any tension). Unfortunately, this procedure can hasten two potentially undesirable long term results. First, although the short wrap may help overcome severe dysphagia much quicker than the “classic” longer wrap; the long-term durability of the “short floppy” Nissen Fundoplication wrap is reduced because the size and the strength of the new “sphincter” muscle (the wrap itself) has now been reduced by more than 50 percent and the number of “fundus joining sutures” has been reduced from 4 to only 3; or, sometimes only 2 sutures. Severe retching and vomiting has frequently caused a “short floppy” Nissen Fundoplication to tear lose. Secondly, many scientific “control group” studies have shown that there is no advantage in “taking down” the short gastric vessels (creating a “floppy"wrap”). Patients who have undergone the 'Classic” Nissen Fundoplication surgery have reported the same results concerning dysphagia at 6 months and beyond, post-surgery. Additionally, there is a reported high incidence of “gas bloat syndrome” and “flatulence” experienced by patients who have had the “short floppy” Nissen Fundoplication surgery - a result NOT REPORTED by Classic Nissen Fundoplication patients (including myself).