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I am looking into revision surgery due to a HNP at L5-S1. I had my first

spinal surgery by the Dr. Winter in Minnesota. In l974 I had the

Harrington rod instrumentation for scoliosis. They fused C7-L4-5, that's right!

As far as I know I have the longest fusion in history, unless anyone out there

can top that, and I sincerely hope not. I would not wish this disease on

anyone. I had a laminectomy in l983 for bone spurs in my thoracic area. In

l996 I fell on Mexican tile breaking the lower hook off the rod and scraping my

spinal cord causing L3-4 thru S1 damage. I live with chronic lbp with

bilateral radicular pain. I had the rod removed in l996. I had to undergo a

diskectomy in 2000 with a titanium plate and screws to fuse C3-C7. I now can

add chronic migraine H/A's, neck and bilateral upper arm pain to my list of

problems. I just found out after weeks of increasing low back pain and bilat

leg pain which became just excruciating last weekend, that I have a HNP at

L5-S1. I will have yet another MRI done and more nerve studies done next week

to find out the extent of the herniation. OH JOY! I am becoming increasingly

aware that because of this dreadful scoliosis that I am basically crumbing. I

have been disabled for 5 years. I have a wonderful supportive husband and

teenage son. I am feeling very sad, angry, and discouraged. I have been

researching the revision surgery treatment. I would love to hear from anyone

else who has been thru this horrendous sounding surgery, and has had a positive

story to pass on. Of course I would love to hear some words of kindness and

support as well. You are all very courageous persons out there!! Thank God for

this group. Sincerely Londa

funinthekeys@... wrote: Elissa,

I went to Dr. Errico, New York University Hospital, New York City. He

is kind, knowledgable, very experienced and was recommended to me by a

retired scoliosis surgeon who said, " you will do no better than this doctor. "

His assistant is Rose and she is wonderful too. Their phone number is

(212) 263-7182 . I traveled from Florida to see him. Best wishes on all your

research. Barbara

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  • 6 years later...
  • 1 year later...

I had mine done that way at Cedars Sinai in Los Angeles, California

in 2004 (I think). They are the only place in the US that apparently

does them that way. I was a mess before, losing weight and couldn't

even drink water. Now I eat everything, bread, meat, salad. I do

wash down with water at the end of the meal.

IT is a controversial subject here, I'll warn you. There are other

surgeons that use this method, but for other things. For years the

research has been more in favor, in general, of lap w/ a wrap. My

surgeons feel the wrap can cause more problems by being too tight or

too loose. Most lap patients require PPI's the rest of their lives.

I don't take any and have no reflux.

I've stayed in touch w/ several patients that also had the same

surgery. They all eat almost normally, drink water after a meal and

are about the same as me, no meds etc. All that I know have had

similar success. There is one here, that has to take PPI's Deborah,

she also has other health issues.

My advice... don't be concerned with the method as much as getting to

the surgeon that is most feasible for you financially and

physically. None of us that post here are experts in surgical

techniques. The experience of the surgeon is absolutely the most

important. I wouldn't ask a lap surgeon to do it VATS and vice

versa.

The VATS (videoassisted thorascopically Surgery) method can be more

painful at first, it can be a longer hospital stay and you may be on

higher level of meds afterward. I'm talking a day's difference in

stay, usually, stronger meds for a few days... not a huge difference.

If the opinions differ, ask each surgeon why, if you see them again.

I'm guessing the VATS surgeon will say it is because VATS doesn't

need a wrap. The lap surgeon, they usually fall back on old

research. Many years ago, both techniques were tried and lap was

found to be better and less hospital time and less technical training

was required, because VATS surgeons go through the chest cavity.

Go with the surgeon w/ the most experience. Ask if each surgeon can

and does do other kinds of surgeries and if so why they think either

method is better.

At the end, go to the surgeon that does the most successful surgeries

at location that is feasible to you physically and financially.

http://www.cedars-sinai.edu/1526.html

This link explains the use of VATS at Cedars, but for lung surgery.

In general, this is the same discussion they have told me and others

for using VATS for achalasia. This will give you some information

if you speak to the surgeons again.

This is the link to their esophageal center...

http://www.csmc.edu/5862.html

they don't go into the discussion nearly as much... probably a

difference in department heads, marketing or something.

http://www.csmc.edu/5865.html

Again... the surgeon and the experience level are most important.

Think of what you do in life, remember the first few times you did it

and how much you learned. If you do it all the time or just some of

the time now... say even mowing the lawn... are you better at it when

you do it only every 3 months or when you do it every day? All lap

surgeries aren't the same, you want the surgeon who does the most

heller myotomies.

>

>

> Our meeting was with a thoracic surgeon who does *all* the

myotomies at

> this hospital - so he has experience. He does open myotomies

> thoracoscopically.

>

> He said we had two options with him: open myotomy or lower

> oesophagectomy.

>

> All the reading I've done is related to laparoscopic Heller-dor

> operation.

>

> So this thoracic surgeon is going to refer us to an abdominal

surgeon in

> another city for a second opinion.

>

> This will take a few weeks.

>

> Thoracic surgeon says he will put us in touch with a person who has

had

> both ops (we are assuming he will choose people who've had

successful

> outcomes!) which may be helpful.

>

> I've obviously got more reading to do because I've hardly come

across

> any thoracoscopic open myotomy research articles - probably because

I've

> assumed the op would be laparoscopic.

>

> He says there is no need for a fundoplication or anti-reflux

procedure

> when the surgery is entered via the thoracic route.

>

> This is from his own research:

> http://ejcts.ctsnetjournals.org/cgi/content/abstract/34/2/423

> <http://ejcts.ctsnetjournals.org/cgi/content/abstract/34/2/423>

>

> This is from a separate article:

>

> " Although greater experience is required, the preliminary results of

> this study suggest that robot-assisted thoracoscopic Heller Myotomy

> without an antireflux procedure may represent an excellent

alternative

> to laparoscopic myotomy with an antireflux procedure. "

>

> http://meeting.chestjournal.org/cgi/content/abstract/132/4/660

> <http://meeting.chestjournal.org/cgi/content/abstract/132/4/660>

>

> Any ideas, please?

>

>

>

>

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... I reread your post. Are you confusing open myotomy vs.

VATS? You mentioned Video-Assisted, which is minimally invasive,

just some holes. (I say JUST because it has been 5 years and we

forget the pain)... or do you mean an open myotomy, which is a LONG

cut from the rib cage all the way around to the back? That is where

they cut you wide open and stick their hands in you? The esophageal

removal can be open or minimally invasive also, I think.

VATS and lap methods are minimally invasive w/ cameras.

It is confusing and the surgeons expect that we understand the

differences. My surgeon kept pointing to rib area, and I didn't get

it until I woke up from surgery with holes in my ribs, armpit and

chest, and back.

If you need help there are diagrams here and there. Don't be afraid

to ask questions.

>

>

> Our meeting was with a thoracic surgeon who does *all* the

myotomies at

> this hospital - so he has experience. He does open myotomies

> thoracoscopically.

>

> He said we had two options with him: open myotomy or lower

> oesophagectomy.

>

> All the reading I've done is related to laparoscopic Heller-dor

> operation.

>

> So this thoracic surgeon is going to refer us to an abdominal

surgeon in

> another city for a second opinion.

>

> This will take a few weeks.

>

> Thoracic surgeon says he will put us in touch with a person who has

had

> both ops (we are assuming he will choose people who've had

successful

> outcomes!) which may be helpful.

>

> I've obviously got more reading to do because I've hardly come

across

> any thoracoscopic open myotomy research articles - probably because

I've

> assumed the op would be laparoscopic.

>

> He says there is no need for a fundoplication or anti-reflux

procedure

> when the surgery is entered via the thoracic route.

>

> This is from his own research:

> http://ejcts.ctsnetjournals.org/cgi/content/abstract/34/2/423

> <http://ejcts.ctsnetjournals.org/cgi/content/abstract/34/2/423>

>

> This is from a separate article:

>

> " Although greater experience is required, the preliminary results of

> this study suggest that robot-assisted thoracoscopic Heller Myotomy

> without an antireflux procedure may represent an excellent

alternative

> to laparoscopic myotomy with an antireflux procedure. "

>

> http://meeting.chestjournal.org/cgi/content/abstract/132/4/660

> <http://meeting.chestjournal.org/cgi/content/abstract/132/4/660>

>

> Any ideas, please?

>

>

>

>

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Thank you for your help.

When I say open myotomy I meant without a wrap, I wasn't refering to

the surgical incisions.

This thoracic surgeon aims to do the myotomy thoracoscopically - so

yes, holes in chest area.

The abdominal surgeon we'll see for his viewpoint would also aim to do

the op laparoscopically but if they have to open him up, then that's

what they'll have to do.

Hubby gives his permission to open him up (long scar) if need be and

do the ectomy if it comes to that.

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Hi

Who is your surgeon and where does she/he propose to do the surgery? Is it far

from where you live? Good Luck on your 2nd opinion. Keep us all informed.

________________________________

From: melanie32uk <melanie32uk@...>

achalasia

Sent: Monday, February 9, 2009 5:47:14 PM

Subject: 2nd opinion

Our meeting was with a thoracic surgeon who does *all* the myotomies at

this hospital - so he has experience. He does open myotomies

thoracoscopically.

He said we had two options with him: open myotomy or lower

oesophagectomy.

All the reading I've done is related to laparoscopic Heller-dor

operation.

So this thoracic surgeon is going to refer us to an abdominal surgeon in

another city for a second opinion.

This will take a few weeks.

Thoracic surgeon says he will put us in touch with a person who has had

both ops (we are assuming he will choose people who've had successful

outcomes!) which may be helpful.

I've obviously got more reading to do because I've hardly come across

any thoracoscopic open myotomy research articles - probably because I've

assumed the op would be laparoscopic.

He says there is no need for a fundoplication or anti-reflux procedure

when the surgery is entered via the thoracic route.

This is from his own research:

http://ejcts. ctsnetjournals. org/cgi/content/ abstract/ 34/2/423

<http://ejcts. ctsnetjournals. org/cgi/content/ abstract/ 34/2/423>

This is from a separate article:

" Although greater experience is required, the preliminary results of

this study suggest that robot-assisted thoracoscopic Heller Myotomy

without an antireflux procedure may represent an excellent alternative

to laparoscopic myotomy with an antireflux procedure. "

http://meeting. chestjournal. org/cgi/content/ abstract/ 132/4/660

<http://meeting. chestjournal. org/cgi/content/ abstract/ 132/4/660>

Any ideas, please?

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Hi ,

The thoracic surgeon is , Royal Infirmary, Edinburgh.

The 2nd opinion surgeon will be in Glasgow which is about 45min - 1

hour drive depending on which part of Glasgow. We don't know who or

where exactly the 2nd opinion is yet.

Just waiting on an appointment letter.....

<christine.hulmes@...> wrote:

>

> Hi

> Who is your surgeon and where does she/he propose to do the surgery?

Is it far from where you live? Good Luck on your 2nd opinion. Keep us

all informed.

>

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