Pros and Cons of Nissen Wrap

The Nissen fundoplication wrap is a surgical procedure that wraps the top part of the stomach to form a one way valve between the esophagus and the remainder of the stomach. Nissen fundoplication wrap surgeries are performed as a treatment option for esophageal acid reflux. Most often the Nissen fundoplication wrap is a laparoscopic surgical procedure. There are situations in which the surgery must be performed with a traditional cut. Additionally, the Nissen fundoplication wrap may be performed in conjunction with the placement of a feeding tube.

Pros

• Having a Nissen fundoplication wrap usually ends the need for reflux medications.

  The wraps are usually successful at ending esophageal reflux, which will allow the esophagus time to heal any erosions.

  A Nissen fundoplication will reduce the chances an infant will choke during the night due to severe reflux.

Cons

• There is a long recovery period from a Nissen wrap surgery. Swallowing may be difficult especially for foods that are dry.

  Bloating from gas buildup is a problem identified by people who have had Nissen fundoplications. This is due to your inability to belch after a stomach wrap.

  Vomiting is not an option for most people after the wrap has been installed.

  In some cases, food that has been successfully swallowed is still too big to fit through the wrap itself. This causes the food to pool on top of the wrap in the esophagus. If the food does not dissolve a surgeon will need to take it out while you are under general anesthesia.

  Dysphagia (a difficulty or inability to swallow) can occur.

  Retching is common in children after a Nissen fundoplication. This condition can be controlled with medication.

Tightening of the Wrap

• The wrap may be too tight, in which case, you will need to be placed under general anesthesia again so the surgeon can dilate the valve to make it bigger.

Loosening of the Wrap

• Over time the wrap can loosen. This may cause you to begin refluxing again. If you believe this has happened to you, make an appointment for evaluation with your gastroenterologist. A swallow study can be performed

Other Options

• The Nissen fundoplication is only one surgical option to people who suffer with reflux. An improved wrap style is called the Toupet wrap, which is a modification of the Nissen wrap. The Nissen wrap goes all the way around the esophagus, the Toupet wrap leaves a gap. This gap allows you to belch after the surgery and return to full activity after only twelve days.