Kristina sent us this question: “How effective are partial fundoplications? I have a 3 cm sliding hiatal hernia. I’m concerned about the inability to vomit with Nissen fundoplication?”
Dear Kristina,
Partial fundoplication also known as Toupet fundoplication is as effective as Nissen or 360-degree fundoplication in terms of acid reflux control. Fundoplication surgery, partial or full, creates a one-way valve; Food gets inside the stomach, but stomach content cannot reflux back into esophagus. Consequently, both Nissen and Toupet fundoplications prevent vomiting.
So, what happens if you get food poisoning or catch a stomach bug? You will dry heave and feel nauseated, but you will not vomit. Instead, your stomach will empty its content downward into intestines. You may develop diarrhea as your intestines are flushing the bug out. You will not feel any additional discomfort or pain because you cannot vomit in the setting of Nissen or Toupet fundoplication.
At Houston Heartburn and Reflux Center, Nissen fundoplication is offered to most of our acid reflux patients. Nissen fundoplication is the gold standard treatment for acid reflux. A properly performed Nissen fundoplication, in expert hands, is durable, effective, reliable, and safe. Toupet Fundoplication is only used when patient has poor esophageal motility on manometry testing. In rare cases, gastric fundus is too small to construct a floppy Nissen fundoplication and a partial wrap is offered instead.