Guest guest Posted April 15, 2012 Report Share Posted April 15, 2012 A thoracic surgeon who did my HM and eventually my oesophagectomy told me catagoracally that after having open surgery you cannot repeat cannot have lap surgery. You must have open surgery again if the HM is to be repeated. Sorry about the bad news but it has something to do with internal scar tissue and adhessions from the previous surgery preventing them doing the lap version of the HM. from the UK ________________________________ From: Faith <weissf@...> achalasia Sent: Sunday, April 15, 2012 2:47 AM Subject: repeat HM Â I read that repeat HM is usually done as an open procedure, not a lap. I have already had a thoracic HM in the early 1990s. If I need a second, does anyone know if they can do a lap HM? Also, how hard is the recovery from a lap if you have minimal assistance for the 2 weeks following, as in your on your own pretty much? Thanks. Faith Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 15, 2012 Report Share Posted April 15, 2012 , I think you're right about the open surgery. However, Faith wasn't clear as to whether her earlier Heller was open or *transthoracic* (though my guess is it WAS transthoracic, simply because most peeps don't even use the term thoracic unless it WAS. . . ). Heck, most of us just say Heller, rather than " Heller myotomy " eh? In which case, a lap redo is VERY possible. . . . http://online.liebertpub.com/doi/abs/10.1089/109264203322656487 And Faith -- after my Heller (lap), my kid brought me home, stayed till noon the next day. I have a big rough/bouncy puppy, I haul my own water in buckets, and I'm 71. I did fine. Sure you will, too. Just make sure you've stocked up at the grocery store *before* surgery. xox > > A thoracic surgeon who did my HM and eventually my oesophagectomy told me catagoracally that after having open surgery you cannot repeat cannot have lap surgery. You must have open surgery again if the HM is to be repeated. Sorry about the bad news but it has something to do with internal scar tissue and adhessions from the previous surgery preventing them doing the lap version of the HM. > from the UK > > > ________________________________ > From: Faith <weissf@...> > achalasia > Sent: Sunday, April 15, 2012 2:47 AM > Subject: repeat HM > > > > Â > > I read that repeat HM is usually done as an open procedure, not a lap. I have already had a thoracic HM in the early 1990s. If I need a second, does anyone know if they can do a lap HM? > > Also, how hard is the recovery from a lap if you have minimal assistance for the 2 weeks following, as in your on your own pretty much? > > Thanks. > > Faith > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 15, 2012 Report Share Posted April 15, 2012 Thanks , Yes, it was trans thoracic. I have a giant scar from my back to my front. They didn't do Laps back in the early 90's. I have an abdominal scar from a fundlipication, also in the 1990's. They also, where I went, didn't do them at the same time. It was at a small army hospital and I bet the surgeon couldn't have done more than a handful in his entire career. I would have to be able to take care of myself regardless of the type of surgery. , You give me hope! Take care, Faith Sent from my iPod On Apr 15, 2012, at 9:42, " puddleriver13 " <puddleriver13@...> wrote: > , I think you're right about the open surgery. However, Faith wasn't clear as to whether her earlier Heller was open or *transthoracic* (though my guess is it WAS transthoracic, simply because most peeps don't even use the term thoracic unless it WAS. . . ). Heck, most of us just say Heller, rather than " Heller myotomy " eh? In which case, a lap redo is VERY possible. . . . > > http://online.liebertpub.com/doi/abs/10.1089/109264203322656487 > > And Faith -- after my Heller (lap), my kid brought me home, stayed till noon the next day. I have a big rough/bouncy puppy, I haul my own water in buckets, and I'm 71. I did fine. Sure you will, too. Just make sure you've stocked up at the grocery store *before* surgery. > > xox > > > > > > > A thoracic surgeon who did my HM and eventually my oesophagectomy told me catagoracally that after having open surgery you cannot repeat cannot have lap surgery. You must have open surgery again if the HM is to be repeated. Sorry about the bad news but it has something to do with internal scar tissue and adhessions from the previous surgery preventing them doing the lap version of the HM. > > from the UK > > > > > > ________________________________ > > From: Faith <weissf@...> > > achalasia > > Sent: Sunday, April 15, 2012 2:47 AM > > Subject: repeat HM > > > > > > > > Â > > > > I read that repeat HM is usually done as an open procedure, not a lap. I have already had a thoracic HM in the early 1990s. If I need a second, does anyone know if they can do a lap HM? > > > > Also, how hard is the recovery from a lap if you have minimal assistance for the 2 weeks following, as in your on your own pretty much? > > > > Thanks. > > > > Faith > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 15, 2012 Report Share Posted April 15, 2012 I was home alone after mine hubby was at work. I did fine. Sent from my iPhone Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 15, 2012 Report Share Posted April 15, 2012 A lap redo is possible if the first HM was a lap operation but if the first operation was an open one then a lap operation is not possible as a second operation due to scar tissue and a buildup of adhesions. A Thoracic surgeon told me this. from the UK ________________________________ From: puddleriver13 <puddleriver13@...> achalasia Sent: Sunday, April 15, 2012 3:42 PM Subject: Re: repeat HM  , I think you're right about the open surgery. However, Faith wasn't clear as to whether her earlier Heller was open or *transthoracic* (though my guess is it WAS transthoracic, simply because most peeps don't even use the term thoracic unless it WAS. . . ). Heck, most of us just say Heller, rather than " Heller myotomy " eh? In which case, a lap redo is VERY possible. . . . http://online.liebertpub.com/doi/abs/10.1089/109264203322656487 And Faith -- after my Heller (lap), my kid brought me home, stayed till noon the next day. I have a big rough/bouncy puppy, I haul my own water in buckets, and I'm 71. I did fine. Sure you will, too. Just make sure you've stocked up at the grocery store *before* surgery. xox > > A thoracic surgeon who did my HM and eventually my oesophagectomy told me catagoracally that after having open surgery you cannot repeat cannot have lap surgery. You must have open surgery again if the HM is to be repeated. Sorry about the bad news but it has something to do with internal scar tissue and adhessions from the previous surgery preventing them doing the lap version of the HM. > from the UK > > > ________________________________ > From: Faith <weissf@...> > achalasia > Sent: Sunday, April 15, 2012 2:47 AM > Subject: repeat HM > > > >  > > I read that repeat HM is usually done as an open procedure, not a lap. I have already had a thoracic HM in the early 1990s. If I need a second, does anyone know if they can do a lap HM? > > Also, how hard is the recovery from a lap if you have minimal assistance for the 2 weeks following, as in your on your own pretty much? > > Thanks. > > Faith > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 15, 2012 Report Share Posted April 15, 2012 Ah so you had a trans thioracic operation like me. Then i am afraid that it is not possible to have an open operation followed by a lap operation a Thoracic Consultant experienced in these operations told me this. from the UK ________________________________ From: Faith Weiss <weissf@...> " achalasia " <achalasia > Cc: " achalasia " <achalasia > Sent: Sunday, April 15, 2012 4:02 PM Subject: Re: Re: repeat HM  Thanks , Yes, it was trans thoracic. I have a giant scar from my back to my front. They didn't do Laps back in the early 90's. I have an abdominal scar from a fundlipication, also in the 1990's. They also, where I went, didn't do them at the same time. It was at a small army hospital and I bet the surgeon couldn't have done more than a handful in his entire career. I would have to be able to take care of myself regardless of the type of surgery. , You give me hope! Take care, Faith Sent from my iPod On Apr 15, 2012, at 9:42, " puddleriver13 " <puddleriver13@...> wrote: > , I think you're right about the open surgery. However, Faith wasn't clear as to whether her earlier Heller was open or *transthoracic* (though my guess is it WAS transthoracic, simply because most peeps don't even use the term thoracic unless it WAS. . . ). Heck, most of us just say Heller, rather than " Heller myotomy " eh? In which case, a lap redo is VERY possible. . . . > > http://online.liebertpub.com/doi/abs/10.1089/109264203322656487 > > And Faith -- after my Heller (lap), my kid brought me home, stayed till noon the next day. I have a big rough/bouncy puppy, I haul my own water in buckets, and I'm 71. I did fine. Sure you will, too. Just make sure you've stocked up at the grocery store *before* surgery. > > xox > > > > > > > A thoracic surgeon who did my HM and eventually my oesophagectomy told me catagoracally that after having open surgery you cannot repeat cannot have lap surgery. You must have open surgery again if the HM is to be repeated. Sorry about the bad news but it has something to do with internal scar tissue and adhessions from the previous surgery preventing them doing the lap version of the HM. > > from the UK > > > > > > ________________________________ > > From: Faith <weissf@...> > > achalasia > > Sent: Sunday, April 15, 2012 2:47 AM > > Subject: repeat HM > > > > > > > > Â > > > > I read that repeat HM is usually done as an open procedure, not a lap. I have already had a thoracic HM in the early 1990s. If I need a second, does anyone know if they can do a lap HM? > > > > Also, how hard is the recovery from a lap if you have minimal assistance for the 2 weeks following, as in your on your own pretty much? > > > > Thanks. > > > > Faith > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 15, 2012 Report Share Posted April 15, 2012 Faith, most states have *some* form of gubbmint home health available if you ask. The hospital social workers are very familiar with resources. Also churches, friends, and even casual neighbors, if they know, are wonderfully at hand! I have a neighbor I hardly ever deal with who suddenly seemed to *want* to do my grocery shopping for me, lo! I did let her for a couple of weeks, but truth is, I could have done it myself. Post op stock up for me was: LOTS of soup (chicken noodle, mushroom, tomato), LOTS of crackers (soda, ritz, graham), LOTS of frozen chicken quarters for crockpotting/pate/soup/salad, LOTS (too much really, lol!) of ice cream, LOTS of butter, and cream cheese (I make a mean low carb cheesecake!), LOTS of chocolate. Talk about comfort food, grin. . . . The crackers, BTW, work as rafts for cheese, butter, cream cheese, peanut butter -- and ALL of them become soft food once you chew them, and follow with a wet swallow! I have a friend, incidentally, who just had a whole hip replacement, and was home and on her own pretty much after three days!! Another who was back at work in TWO. So, we're more capable than the docs think we are (Lord willing and the crick don't rise!). xox > > > > > > A thoracic surgeon who did my HM and eventually my oesophagectomy told me catagoracally that after having open surgery you cannot repeat cannot have lap surgery. You must have open surgery again if the HM is to be repeated. Sorry about the bad news but it has something to do with internal scar tissue and adhessions from the previous surgery preventing them doing the lap version of the HM. > > > from the UK > > > > > > > > > ________________________________ > > > From: Faith <weissf@> > > > achalasia > > > Sent: Sunday, April 15, 2012 2:47 AM > > > Subject: repeat HM > > > > > > > > > > > > Â > > > > > > I read that repeat HM is usually done as an open procedure, not a lap. I have already had a thoracic HM in the early 1990s. If I need a second, does anyone know if they can do a lap HM? > > > > > > Also, how hard is the recovery from a lap if you have minimal assistance for the 2 weeks following, as in your on your own pretty much? > > > > > > Thanks. > > > > > > Faith > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 15, 2012 Report Share Posted April 15, 2012 -- read the link: that's *exactly* what they did. One of them was the famous Dr. Patti, now in Chicago. Transthoracic isn't considered an Open Heller. I gather that an Open Heller, is from the front, and a following lap would conflict. But with the Transthoracic, here's no scar tissue conflict, because they go in different pathways. Howsomever, since she had a fundoplication separately, and didn't mention if it was open or lap, we really don't know. Hope she lets us know what is decided. Soon. Waiting is agony. xox > > > > > > A thoracic surgeon who did my HM and eventually my oesophagectomy told me catagoracally that after having open surgery you cannot repeat cannot have lap surgery. You must have open surgery again if the HM is to be repeated. Sorry about the bad news but it has something to do with internal scar tissue and adhessions from the previous surgery preventing them doing the lap version of the HM. > > > from the UK > > > > > > > > > ________________________________ > > > From: Faith <weissf@> > > > achalasia > > > Sent: Sunday, April 15, 2012 2:47 AM > > > Subject: repeat HM > > > > > > > > > > > > Â > > > > > > I read that repeat HM is usually done as an open procedure, not a lap. I have already had a thoracic HM in the early 1990s. If I need a second, does anyone know if they can do a lap HM? > > > > > > Also, how hard is the recovery from a lap if you have minimal assistance for the 2 weeks following, as in your on your own pretty much? > > > > > > Thanks. > > > > > > Faith > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 15, 2012 Report Share Posted April 15, 2012 My fund was open. Faith Sent from my iPod On Apr 15, 2012, at 15:24, " puddleriver13 " <puddleriver13@...> wrote: > -- read the link: that's *exactly* what they did. One of them was the famous Dr. Patti, now in Chicago. Transthoracic isn't considered an Open Heller. I gather that an Open Heller, is from the front, and a following lap would conflict. But with the Transthoracic, here's no scar tissue conflict, because they go in different pathways. Howsomever, since she had a fundoplication separately, and didn't mention if it was open or lap, we really don't know. Hope she lets us know what is decided. Soon. Waiting is agony. > > xox > > > > > > > > > > A thoracic surgeon who did my HM and eventually my oesophagectomy told me catagoracally that after having open surgery you cannot repeat cannot have lap surgery. You must have open surgery again if the HM is to be repeated. Sorry about the bad news but it has something to do with internal scar tissue and adhessions from the previous surgery preventing them doing the lap version of the HM. > > > > from the UK > > > > > > > > > > > > ________________________________ > > > > From: Faith <weissf@> > > > > achalasia > > > > Sent: Sunday, April 15, 2012 2:47 AM > > > > Subject: repeat HM > > > > > > > > > > > > > > > > Â > > > > > > > > I read that repeat HM is usually done as an open procedure, not a lap. I have already had a thoracic HM in the early 1990s. If I need a second, does anyone know if they can do a lap HM? > > > > > > > > Also, how hard is the recovery from a lap if you have minimal assistance for the 2 weeks following, as in your on your own pretty much? > > > > > > > > Thanks. > > > > > > > > Faith > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 15, 2012 Report Share Posted April 15, 2012 Faith wrote: > > I read that repeat HM is usually done as an open procedure, not a lap. > I have already had a thoracic HM in the early 1990s. If I need a > second, does anyone know if they can do a lap HM? > Thoracotomy is an incision into the chest. Transthoracic means that surgery was done through the chest. Thoracoscopy means it was done in the chest endoscopically. Laparotomy is an incision into the abdomen or a surgery done in the abdomen. Laparoscopy is surgery done in the abdomen endoscopically. The chest and abdomen are separated by the diaphragm. The Lower Esophageal Sphincter (LES), where the esophagus and stomach join is in a passage through the diaphragm called the hiatus. The heller myotomy (HM) is done at the LES. Sometimes it is done from the chest and sometimes it is done from the abdomen (lap). Now there is another type of endoscopic surgery called POEM or TEEM which go in through the mouth and esophagus to make the incision to enter for the surgery. If an HM was done open transthoracic it is often possible to do a redo or second HM laparoscopically. If an HM was done open laparotomy then a redo or second HM may be possible thoracoscopically. The idea is to go in from the opposite approach where there should be little scarring. Sometime such a surgery, started endoscopically but because of too much scarring, is converted to open. Some doctors will simply assume too much scarring and just start open. With the new POEM and TEEM methods it may not matter how the myotomy was done before, but not many surgeons are doing these yet. notan Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 15, 2012 Report Share Posted April 15, 2012 Notan, Do you know if Mayo (rochester) is doing it? My appointment is in 3 weeks. Thanks, Faith Sent from my iPod On Apr 15, 2012, at 16:37, notan ostrich <notan_ostrich@...> wrote: > Faith wrote: > > > > I read that repeat HM is usually done as an open procedure, not a lap. > > I have already had a thoracic HM in the early 1990s. If I need a > > second, does anyone know if they can do a lap HM? > > > > Thoracotomy is an incision into the chest. > Transthoracic means that surgery was done through the chest. > Thoracoscopy means it was done in the chest endoscopically. > > Laparotomy is an incision into the abdomen or a surgery done in the > abdomen. > Laparoscopy is surgery done in the abdomen endoscopically. > > The chest and abdomen are separated by the diaphragm. The Lower > Esophageal Sphincter (LES), where the esophagus and stomach join is in a > passage through the diaphragm called the hiatus. The heller myotomy (HM) > is done at the LES. Sometimes it is done from the chest and sometimes it > is done from the abdomen (lap). Now there is another type of endoscopic > surgery called POEM or TEEM which go in through the mouth and esophagus > to make the incision to enter for the surgery. > > If an HM was done open transthoracic it is often possible to do a redo > or second HM laparoscopically. If an HM was done open laparotomy then a > redo or second HM may be possible thoracoscopically. The idea is to go > in from the opposite approach where there should be little scarring. > Sometime such a surgery, started endoscopically but because of too much > scarring, is converted to open. Some doctors will simply assume too much > scarring and just start open. > > With the new POEM and TEEM methods it may not matter how the myotomy was > done before, but not many surgeons are doing these yet. > > notan > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 15, 2012 Report Share Posted April 15, 2012 Faith wrote: > > Do you know if Mayo (rochester) is doing it? > You mean POEM and TEEM. Not that I know of. They are studying something that seems to be the same but they call it, submucosal endoscopy with mucosal safety flap (SEMF). As far as I know they have only done it on pigs. Maybe you could be a first. ;-) A comparative study of endoscopic full-thickness and partial-thickness myotomy using submucosal endoscopy with mucosal safety flap (SEMF) technique. http://www.ncbi.nlm.nih.gov/pubmed/22258295 ville has also done some work on pigs, using NOTES (all these techniques are NOTES). Pilot study of transesophageal endoscopic surgery: NOTES esophagomyotomy, vagotomy, lymphadenectomy. http://www.ncbi.nlm.nih.gov/pubmed/18803520 Rochester also did some NOTES on pigs before the other studies. Transesophageal mediastinoscopy by submucosal endoscopy with mucosal flap safety valve technique. http://www.ncbi.nlm.nih.gov/pubmed/17383463 notan Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 15, 2012 Report Share Posted April 15, 2012 Visualizing a pig on the operating table makes me feel like squealing! ________________________________ From: notan ostrich <notan_ostrich@...> achalasia Sent: Sunday, April 15, 2012 6:16 PM Subject: Re: repeat HM Â Faith wrote: > > Do you know if Mayo (rochester) is doing it? > You mean POEM and TEEM. Not that I know of. They are studying something that seems to be the same but they call it, submucosal endoscopy with mucosal safety flap (SEMF). As far as I know they have only done it on pigs. Maybe you could be a first. ;-) A comparative study of endoscopic full-thickness and partial-thickness myotomy using submucosal endoscopy with mucosal safety flap (SEMF) technique. http://www.ncbi.nlm.nih.gov/pubmed/22258295 ville has also done some work on pigs, using NOTES (all these techniques are NOTES). Pilot study of transesophageal endoscopic surgery: NOTES esophagomyotomy, vagotomy, lymphadenectomy. http://www.ncbi.nlm.nih.gov/pubmed/18803520 Rochester also did some NOTES on pigs before the other studies. Transesophageal mediastinoscopy by submucosal endoscopy with mucosal flap safety valve technique. http://www.ncbi.nlm.nih.gov/pubmed/17383463 notan Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 15, 2012 Report Share Posted April 15, 2012 ROFLMEO!! > > Visualizing a pig on the operating table makes me feel like squealing! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 15, 2012 Report Share Posted April 15, 2012 Haaaaaaa... Good one! Sent from my iPhone Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 27, 2012 Report Share Posted April 27, 2012 Yikes - I am so glad they have less invasive procedures now. I already have enough scars from previous surgeries.  I am going to University of Chicago in July and from what I read, they have a less invasive HM that only requires 1 day in the hospital and back to work in a week. I can do without that part...............LOL. I jut got the packet they sent me yesterday but haven't had a chance to read it over yet.     ________________________________ From: Faith Weiss <weissf@...> " achalasia " <achalasia > Cc: " achalasia " <achalasia > Sent: Sunday, April 15, 2012 10:02 AM Subject: Re: Re: repeat HM  Thanks , Yes, it was trans thoracic. I have a giant scar from my back to my front. They didn't do Laps back in the early 90's. I have an abdominal scar from a fundlipication, also in the 1990's. They also, where I went, didn't do them at the same time. It was at a small army hospital and I bet the surgeon couldn't have done more than a handful in his entire career. I would have to be able to take care of myself regardless of the type of surgery. , You give me hope! Take care, Faith Sent from my iPod On Apr 15, 2012, at 9:42, " puddleriver13 " <puddleriver13@...> wrote: > , I think you're right about the open surgery. However, Faith wasn't clear as to whether her earlier Heller was open or *transthoracic* (though my guess is it WAS transthoracic, simply because most peeps don't even use the term thoracic unless it WAS. . . ). Heck, most of us just say Heller, rather than " Heller myotomy " eh? In which case, a lap redo is VERY possible. . . . > > http://online.liebertpub.com/doi/abs/10.1089/109264203322656487 > > And Faith -- after my Heller (lap), my kid brought me home, stayed till noon the next day. I have a big rough/bouncy puppy, I haul my own water in buckets, and I'm 71. I did fine. Sure you will, too. Just make sure you've stocked up at the grocery store *before* surgery. > > xox > > > > > > > A thoracic surgeon who did my HM and eventually my oesophagectomy told me catagoracally that after having open surgery you cannot repeat cannot have lap surgery. You must have open surgery again if the HM is to be repeated. Sorry about the bad news but it has something to do with internal scar tissue and adhessions from the previous surgery preventing them doing the lap version of the HM. > > from the UK > > > > > > ________________________________ > > From: Faith <weissf@...> > > achalasia > > Sent: Sunday, April 15, 2012 2:47 AM > > Subject: repeat HM > > > > > > > > Â > > > > I read that repeat HM is usually done as an open procedure, not a lap. I have already had a thoracic HM in the early 1990s. If I need a second, does anyone know if they can do a lap HM? > > > > Also, how hard is the recovery from a lap if you have minimal assistance for the 2 weeks following, as in your on your own pretty much? > > > > Thanks. > > > > Faith > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
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