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Re: 2nd nissen fundo

From: S. Carvajal, M.D.
Date: 05/17/00
Time: 22:28:55

Comments

The recommendation of a vagatomy along with a Nissen fundoplication era it is peculiar. I did not know of any studies or experts in the field that advocate the use of vagotomy. There are multiple vagotomy type operations which can be done including a truncal vagotomy or a parietal cell vagotomy. To do the latter laparoscopically is difficult and has been attempted only by a few surgeons. If a truncal vagotomy is done, pyloroplasty must be done in addition to increase gastric emptying. Additional tests that should be done include nuclear medicine gastric emptying study, repeat esophageal manometry, and repeat 24-hour pH study. Prior to proceeding with the proposed therapy, I would recommend a second opinion.

Last changed: January 12, 2008