Has anyone had a 2nd HM surgery? Is this even possible?

Digestive health
1

The first surgery wasn't a success. Was wondering if a 2nd is even possible.

2

Hi yes it is possible. I had a HM in October 2013 which worked for a short period but then things got worse again and the operation was repeated in march 2016. MY surgeon said it is possible to do it but technically it is more difficult because of the scar tissue that would have formed and the risk of perforation is much greater. He has already said there will not be a third time and that means a possible POEM op if it needs to be done again.

 

3

Thank you for replying...I appreciate the info. I had HM w/dor fundiplication in 2012 which only worked good, for about a year. Fast forward to now, and I'm back to square one complete with aspirating and choking on just about everything. Saw my dr last year and had an endoscopy in October of 2015 that helped for awhile. Have you had much success with the 2nd surgery??

4

Initially I would have said no. Things felt much the same and I am waiting to see

My surgeon again. But I think I am better than I was.. I can swallow reasonably well

and little gets stuck and I certainly have no reflux or aspiration problems such

As I had before the first surgery. A lot depends on how well the surgeon does at

Getting at all the muscles of the cardia. I do however get a lot of spasms in my lower

Sarcophagus that I treat with paracetamol and drinking cold water and

Simply walking about.

5

I'm glad you've had some success and relief with the 2nd surgery. My surgeon told me he didn't think there was much more he could do for me and the next and last step, would be a 2nd HM. I'm hoping it doesn't come to that, but choking on simple things again, such as a pill and even mashed potatoes, is making me think I need to give him another call. Thank you again!

6

I have similar problem and  had the myotomy in 2008.Now again problem started about in April 2016. Doctors confirmed by UGI Endoscopy and barium swallow test. Doctors recommended for POEM or repeat myotomy.However one Gastroenterologist recommended medicine ""calcigard 10mg and Beson tablet before meals, With this medicine I am able to swallow food and gained weght. I am taking this medicine since last two months. You cal also share this exprience with  Gastroenterologist and get advice.If any body has exprience with this medicine please share

7

Thank you for replying. What is the POEM procedure that you mentioned?

8

Please refer http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3773853/ for detail of POEM (Per-oral endoscopic myotomy). POEM is conceptually similar to a surgical myotomy without the inherent external incisions and post-operative care associated with surgery.

However Please refer my reply before going for any operationand try medicines after consuting your doctor. 

9

It is, as I understand it, possible to do further surgery after a myotomy, but most surgeons would think twice because of the potential or probability of complications.   From my own understanding I would be sceptical about whether a POEM procedure is possible after a myotomy; this may be a misunderstanding however.

​You may think that your priority could be concentrating on relaxation around eating, and choosing food that does not cause you problems so that you prevent things from getting worse, if possible.

10

Thank you for the info

11

Thank you for replying!

12

My doctor wouldn't do the HM to me.  It isn't effective or long lasting.  If you don't have any scar tissue, find a doctor in your area to do the POEM procedure!  It has a 98% success rate!  I had my surgery last Fri, the 29th of July.  So far, so good.  Will be thrilled when I've gone through the healing process and can eat a full menu tho!

13

Different doctors have varying opinions about POEM.   This is perhaps because it is a new procedure, relatively.   But Heller Myotomy with fundoplication does give significant benefits for 80-90% of the patients it is performed upon.   No doubt in due course there will be a medical consensus about the advantages / disadvantages of POEM, but it is certainly true that the doctors who perform both procedures do believe in them.

14

The HM worked great for about 2yrs but now I'm worse off than before it seems. I'll look into the POEM procedure but I'm not sure it can be done since I've already had the HM w/the dor fundiplication.