Any one havethe Nissen fundoplication prior to VSG

Looking for results of a patient that had the Nissen fundoplication procedure prior to VSG.  My concern is that the Nissen was done for my reflux 8 years ago and has to be reversed to do the VSG. Has the reflux returned after VSG?
Any comments welcome.  This will determine if I move forward with VSG.
Thanks

I had horrible GERD and reflux for many years and I never was a candidate for repair of my haital hernia..not sure why, but I wasn't.  My surgeon told me that he would have to fix my hiatal hernia before he could do the VSG.  I am not sure what he did to fix it, but I have very little problems with GERD/heartburn now.  I take a PPI maybe once a week and it usually has to do with something I ate...overly spicey can do it sometimes.  I know of plenty others that never had reflux prior to VSG, but now can not go a day without taking their PPI.  I would have to say that I would rather take a PPI daily than have stayed so SMO and unhealthy.  Not sure if I have helped you out, but it what was done for me and how I am doing with the end result of the surgery.

I'm going to make a few assumptions based on your post.  If you had a Nissen fundoplication, I assume you had severe reflux that did not respond to medication and did NOT have a hiatal hernia.  I would think twice about a VSG because it CAN worsen reflux for those with GERD, especially if there is no hiatal hernia repair.

My surgeon recommended a RNY for me, but I insisted on a VSG.  Luckily for me, I did have a hiatal hernia which did NOT show up on any of the diagnostics I had prior to surgery, which was repaired.  I still have reflux and take a daily PPI which controls the symptoms.  BUT I can tell that with my sleeve, when I eat something that triggers acid production (primarily spicy food), I have instant and killer reflux!  Do a lot of research if you decide to pursue this path, and find a very skilled surgeon with lots of experience (with BOTH procedures!)

Good luck!

I had a Nissin performed approximately 7 years ago that will be reversed during my VSG surgery. It has been a journey. To begin with, the group I was referred to through Kaiser 1st said they would do the surgery, changed their mind said they would not, and now they are doing it. My surgery is scheduled for 10/6. However, I had upper GI with contrast. Also possible it could become open surgery, longer hospital stay, drain, etc.

Whoops, don't know yet, if my GERD will return, but I am willing to take the meds and watch what I eat. Good luck.

Thanks to all for your response and input.  It is greatly appreciated.  Any other comments  or suggestions are welcome.  I am still on the fence with which direction to go.  My options are to reverse the Nissen and either do the VSG or bypass.

I asked the same question in June and didn't get a response from anyone having a VSG with prior fundo. I think it's rare, although I'm not sure why. I found a bariatric  surgeon in Mexico who is very familiar with fundoplications and he is highly recommended. Several other surgeons wouldn't do a VSG in my situation. I am scheduled for September 26 with Dr. Alberto Aceves in Mexicali Mexico. Now to be clear, Dr Aceves recommended the Gastric Bypass for me based on ADDITIONAL reflux, post VSG. So I think that answers your question about reflux returning. I think it will, and many sleevers report reflux after the VSG when they never had any before. I will have to take a PPI every day going forward, but I already do that anyway (Rabeprazole) because I started getting reflux again, 5 or 6 years after my fundo.  So I choose the VSG over the bypass to avoid malabsorption issues, even though the Gastric Bypass is considered to be the better surgery for GERD. Please note that a VSG with prior fundoplication may be designated as revision surgery, so it may cost more. The extra cost is because the surgeon has to undo the fundo, then do the VSG. Starting September 27, I may be the "poster boy" for VSG with prior Fundoplication. Should be fun! Cheers! Stewart

Thanks so much for your reply.  I have had 2 opinions.  First surgeon said he would not do the VSG because he would have to undo the fundo and that would increse reflux.  My options with him were leaving the fundo and doing a plication or udoing the fundo and doing a bypass.  The second surgeon said he recommended the VSG.  He would undo my fundo and then do a Thal patch which would reduce my chance of increased reflux.  I am not sure what a Thal patch is and how it would do that.  I will pose that question when I talk with him next.  I am a visual person and need to see how it would work.
Good luck with your surgery in September.  I met with the surgeon last week and hoping to get a confidence level from my follow up questions to move forward soon.  Please keep me posted with your progress.  Thanks,  Don

I know this conversation is old...but i just want to chime in on what my surgeon told me.  

I had the nissen fundoplication done 3 years ago and it completely cured my gerd.  

Now i am looking into having gastric bypass rny procedure.  

My dr. said he will leave my nissen wrap in place and put my pouch below the wrap.  

He said the sleeve would require taking down the wrap and having my gerd return.  I asked him..."why cant  you do the sleeve with the wrap in place and he said.."because if we did the sleeve with the wrap in place, the portion of stomach around your esophagus would no longer have a blood supply and that part of the stomach would die"...  

He felt it was better to leave my nissen wrap alone and to the rny procedure by putting my pouch below the wrap.

I sure hope this info helps somebody.  I have searched and searched the internet for doing the rny procedure with a nissen fundoplication and only been able to find one article about it.  It's not a very common procedure but it is done leaving the wrap in place therefore minimizing the risk involved taking it down and damaging the esophagus which in a lot of cases can be fatal.