It is a procedure for those who have recurrent symptoms after a previous Nissen fundoplication. The patient will need a reassessment via scope and X-rays. This procedure is also done via a laparoscopic approach. The doctor takes down the old operation and starts a full redo of the Nissen procedure. The patient may need a mesh. The risks of bleeding and bowel injury are higher, and the patient will have a drain in situ. A post op X-ray is done to assess the operation.

Redo Laparoscopic Nissen Fundoplication is a form of revision surgery conducted after an ineffective Nissen Fundoplication, in which the surgeon corrects recurrent symptoms such as dysphagia, chest pain and heartburn, which are all symptoms that mimic Gastroesophageal Reflux Disease (GERD). The original wrap is removed, and the repair of a slipped wrap or hiatal hernia is performed. This is a complex surgery requiring the skills of a surgical expert like Dr Govender, who first conducts a comprehensive evaluation beforehand. The second attempt at the procedure is performed laparoscopically, and the potential risks remain much higher than in the first attempt.

What happens before surgery?

Dr Govender conducts the following tests before surgery:

• Upper gastrointestinal endoscopy is an investigative procedure used to diagnose issues in the upper gastrointestinal tract. A long, narrow tube (endoscope) is placed through the mouth and navigated down the oesophagus, stomach and initial part of the small intestine (duodenum).
• A barium swallow is considered a critical investigative measure before Redo Nissen Fundoplication to assess the cause of anatomical failure of the initial procedure. Dr Govender evaluates the structure and function of the oesophagus, stomach, and wrap to determine the cause of current reflux symptoms.
• Oesophageal manometry is generally advised prior to a redo Nissen Fundoplication to assess oesophageal motility and function of the muscle to determine the cause of surgical failure, such as a tight or slipped wrap.