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Approximately 1 in 5 American adults suffer from GERD.
If you’re continually upping to dosage on your medications without relief, then NISSEN Fundoplication might offer a solution to your troubles. This minimally invasive surgery has helped thousands, but is it right for you?
Here’s what you need to know.
What Is NISSEN Fundoplication?
Your doctor might refer to this procedure as NISSEN Fundoplication, Lap Nissen, or simply NISSEN. This is a procedure that helps patients affected by GERD (gastrointestinal reflux disease). It is used when conventional medications no longer work.
Medicines for GERD typically decrease acid production in the stomach to minimize damage to the stomach lining or esophagus. In many cases, these medicines aren’t strong enough to solve the issue. Patients that continue to suffer from GERD even with medication can choose the NISSEN procedure.
So, what is the NISSEN procedure?
This surgery aims to solve the issue of a non-functional sphincter that connects the stomach to the esophagus by wrapping a portion of the stomach around the connecting sphincter.
You might be wondering, “How is the NISSEN procedure done?” Most patients are surprised to hear that their stomach can wrap around anything. All the surgery does is take the top part of the stomach and secure around the esophagus.
This part of the stomach, known as the fundus, lies above the esophageal sphincter. This portion is safely wrapped around the opening to the esophagus and sutured shut to recreate the effect of the sphincter.
This new suture is an excellent way to eliminate future reflux and pain with few side effects. Individuals that undergo NISSEN typically no longer require medication or therapy, either.
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What You Need to Know About NISSEN
The Nissen procedure for GERD is a highly effective one, making it a top choice for patients with the issue. Before undergoing this surgery, however, it’s essential to ask, “How Successful is the NISSEN procedure?”
In the short-term, 90% of patients experience an incredibly positive outcome. This means that their GERD or reflux is gone to the point of no longer needing medication. The success rate after the short-term period is mostly dependent on the patient’s lifestyle.
Patients who choose to avoid foods directly linked to their GERD and those who actively maintain their weight find the operations successful for a lifetime. Choosing to eat poorly or gain excess weight can have an adverse reaction, allowing stomach acid to breach the esophagus once more.
Success rates are also tied to safety during and after the procedure. So, is it safe? The answer is yes. NISSEN Fundoplication is an incredibly safe operation with quick recovery time. Less than 10% of patients run into complications like dysphagia (difficulty swallowing).
How safe the operation is for you depends on your biology and lifestyle. Your physician can give you a better insight into how effective NISSEN could be for you. Speaking with the surgeon your physician recommends will further explain whether this operation is for you.
Is it Reversible?
Many patients ask this question as they consider the NISSEN procedure.
The NISSEN procedure for acid reflux is not entirely reversible. Should the need arise for you to undo this operation, there is only so much that surgeons can do.
While the need for a reversal is rare, instances where one is required are comprised of reconstructing the top of the stomach. This can result in nerve damage and complications like the need for a feeding tube. Due to the problematic nature of a reversal, most surgeons refuse to attempt it.
Don’t let that scare you, though.
The need for a reversal is incredibly rare and always coupled with either new medical diagnoses or injury. Just over 95% of patients report nothing but positive benefits even after their five-year check-up.
What to Expect
It takes nearly six weeks to recover from NISSEN Fundoplication, with the first few days spent in the hospital. Without the need for a large incision, your recovery time is quick and pain levels low. Most patients return to daily life after two weeks.
During this time and after, you’ll need to change your diet. Soft foods are always recommended after any surgery, but the nature and location of NISSEN make gradually incorporating solid foods a necessity.
If you’re wondering, “What can I eat before/after NISSEN?” the answer is not much. You want the stomach empty during the operation, which is why most surgeons recommend refraining from eating for 24 hours. Afterward, smoothies are your best friend.
While on the liquid or soft diet, you should expect to experience weight loss. This is beneficial to your condition. Obese patients experience more pain with GERD as their stomachs produce a higher amount of acid to accommodate their diets.
As you heal, expect a little discomfort. Bloating, difficulty burping, and excess gas is all side-effects until your body adjusts to the stomach’s new position.
While the majority of patients experience the elimination of GERD, it does return in roughly 5-10% of patients. These individuals may need the same medicines they relied on previously or to have the surgery redone.
Bloating and discomfort typically subside after the six weeks once the body adjusts, but a handful of patient’s experience increases of both long after the surgery. This is usually accompanied by difficulty swallowing, all of which are caused when the stomach is wrapped too tightly or too high around the esophagus.
Keep in mind that this operation cannot be reversed. Roughly 5% of patients say these complications are just as bothersome as GERD. That means it may not be possible to relieve these symptoms in every case. On the plus side, the use of a suture eliminates device failure, complication, and side effects commonly associated with other GERD operations.
Is NISSEN Fundoplication Worth It?
This is a common question that patients ask, but the answer depends on the individual. GERD is not a dangerous disease, which makes the need for surgery small for most people. You may not need any form of surgery if your condition is easily maintained with medicine, which you can discuss with a qualified professional.
However, a successful NISSEN Fundoplication combined with diet and exercise can eliminate the need for medication. Another aspect to consider is the price of the operation. So, how much does it cost?
The price of a NISSEN procedure ranges from $8,700 to $16,500. That’s a costly out-of-pocket expense for the average patient, which leads many to ask, “Does insurance cover the procedure?” In most cases, it does due to the chronic nature of GERD. Always check with your insurance company, though.
Finally, you need to understand that surgery alone isn’t a fix for GERD. You will need to change your lifestyle after the operation is over by incorporating a healthier diet that avoids reflux triggers and maintaining a healthy weight to keep acid reflux from returning.
Deciding on the NISSEN procedure is entirely your choice. You know how GERD affects you better than anyone. If you’re ready to make the necessary lifestyle changes and have insurance to cover the cost, then you might join the 95% of satisfied patients who have had the surgery.