The Tight Nissen Fundoplication

Sabrina from Houston sent us this question: “I have had acid after the Lap Nissen. It was wrapped too tight I couldn’t get anything down. Any pills that I would take would get stuck. It had to be balloon twice. Now I guess the surgery is over. It wasn’t successful any way. It’s been a year and two months with constant Acid Reflux. I have to do something”.

Dear Sabrina,

Nissen fundoplication is the most effective and reliable treatment for acid reflux disease when properly performed. I have yet to see a Nissen fundoplication patient, at Houston Heartburn and Reflux Center, with persistent acid reflux after surgery. Many factors contribute to success of Nissen fundoplication. Surgeon expertise, knowledge, and understanding of acid reflux pathophysiology and Nissen fundoplication mechanism of action cannot be overemphasized. A tight wrap is indication of poorly performed fundoplication and possibly lack of understanding of how a Nissen fundoplication works. A number of general surgeons believe that Nissen fundoplication creates a high-pressure zone around the bottom of the esophagus to stop acid reflux. They tend to narrow the hiatal opening as much as they can and fail sometimes to create a floppy wrap. The end result is high post-operative dysphagia rate requiring multiple dilation and sometimes revision surgery.

At Houston Heartburn and Reflux Center, our dysphagia rate post Nissen fundoplication is almost zero. We maintain a very high patient satisfaction rate because of our meticulous approach to acid reflux disease. We do one thing and one thing only, but we do it right. We specialize in Nissen fundoplication surgery to achieve a very high success rate and very low complication rate.

I recommend you seek the advice of an experienced acid reflux specialist to evaluate your current problem. Revision Nissen fundoplication may be offered and is still associated with good outcome. There is no need for you to live with constant acid reflux.