before deciding on doing a fundo??
I've been researching them for a couple weeks but there isn't much info to be found.

:hello2: No, we didn't, I think those are new or not used much on children right? I have heard of different treatments but all of them just haven't been around long enough for me to trust in them. We looked into a few but quckly found that they are mailnly being tested on adults.

Not that I trusted in the fundo though! I was scared to death! But, it is the best thing we have ever done and so glad we did it! Let me know what you find out, Lena! :book:

I thought they were only used on adults because they are new and the tools used are too large for little ones. If you find out otherwise please let me know. I will ask when we see our UCLA doc, if anyone does them on kids, I would think they would be one of them. I am pretty desperate with Chelsea, so I will be sure to ask!!!!

Yes, we talked with our surgeon at UCLA about all other treatments, and he said they are just not comfortable enough to be used on kids. They don't know the long term.

Children's hospital of Pittsburgh
University of Chicago Comer's Children's Hospital
Riley Hospital for Children- Indianapolis
Mayo Clinic

I'm sure there are even more.

Lena,
I looked some of those and didn't find where you read that they do these procedures on children. I know that one of them, called Enteryx was recalled by the FDA in Sept. of 2005.

I read about the three others but I only remember two names--- the Endocinch and the Stretta Procedure. The stretta sounds sketchy to me--they kill the nerves in the LES muscle. The Endocinch has always sounded sensable but it says that they do not know the long term effects of these procedures because they are so new. I would be interested to see if 1. An actual childrens hospital performs them regularly and 2. What the outcome has been for any children that have had them done.

I know I asked our GI about it awhile ago and they said that because it is so new it isn't considered. Although many people are anti-Nissen and anti-fundo, it is the only one they know anything about really and have experience to draw on in post operatve treatment. It sucks I know.

Anyone have a Thal done????? I was thinking if it wasn't all the way around would post operative retching occur? That seems to be the biggest problem. Also, if retching did not occur, would it stop the reflux???

Retching is caused by spasms of the diaphram muscle... If retching stopped contents wouldn't be forced back up... I don't know if a thal would make a difference.

Approved for teenagers... I read too quickly.

Minimally invasive procedure helps children with GERD

July 16, 2003
A new minimally invasive procedure is helping children suffering from gastroesophageal reflux disease (GERD), a cause of chronic heartburn. In the Chicago area, the procedure is being performed only at the University of Chicago Children's Hospital (UCCH).
In patients with GERD, fluids from the stomach splash back into the esophagus due to a weakened valve at the stomach's opening. The reflux causes irritation and pain in the esophagus. Left untreated, the condition could lead to esophagitis and even esophageal cancer.
"GERD in infants and children is occurring in almost epidemic proportions," said Donald Liu, MD, PhD, chief of pediatric surgery at UCCH, "although it's not understood why." Several thousand children in America are diagnosed with the disease each year.
Now, a minimally invasive surgical treatment is available. The Stretta System makes this surgery a one-hour, outpatient procedure. Most patients resume normal activities the following day.
A tiny video camera is lowered through the mouth along with the Stretta catheter. The catheter emits radiofrequency energy, which narrows the opening in the area where the esophagus meets the stomach. A tighter valve in the gastroesophageal junction prevents reflux.
Studies have shown that within six months after the procedure, the amount of acid found in a patient's esophagus has been cut by more than half. Several medical and surgical journals have reported no symptoms in up to 80 percent of patients within a three-year period.
Traditional surgery for GERD would involve a large incision in the patient's upper abdomen to reconfigure the esophagus and stomach anatomy to prevent acid reflux. Patients would have to stay in the hospital for several days to weeks as they recover from the surgery.
The Stretta procedure is one of a number of minimally invasive surgeries preformed at UCCH. Patients deemed unsuitable for Stretta become candidates for laparoscopic Nissen Fundoplication, which is performed through "tiny keyhole" incisions. Patients typically are discharged from the hospital less than two days after surgery. Liu performs nearly 100 such procedures on children annually at UCCH.
"Due to the nature of MIS and improved cosmetics, I believe pediatricians will be more willing to consider and recommend surgical intervention," Liu said. "Likewise, patients and their parents will seek the procedure at an earlier age."
Many GERD patients can avoid surgery altogether through lifestyle modifications such as avoiding spicy foods or not eating before bedtime. Over-the-counter and prescription medications can help, but not for all patients. The Stretta procedure is significantly less expensive than lifetime medication. It's also one-fifth the cost of traditional surgery.
Liu believes the concept of avoiding large incisions to perform invasive surgery and causing less post-operative pain are the basis for the current surge of minimally invasive surgery in children.
The Stretta procedure requires no incisions. The FDA approved the technique for adults in 2000 and for the teenage population late last year.
Liu also performs MIS for:

Pyloric stenosis: a disease in which the muscle between the stomach and small bowel becomes enlarged, causing vomiting and dehydration.
Pectus excavatum: more commonly known as funnel chest.
Inflammatory bowel disease: such as Crohn's disease and ulcerative colitis
Tumor resection
Lung biopsies
Myasthenia gravis: muscle weakness due to an autoimmune attack
Pulmonary infections"Soon all surgery will be done this way," Liu predicted.
The University of Chicago Medical Center
Office of Public Affairs
5841 S. Maryland Avenue, MC6063
Chicago, IL 60637
Phone (773) 702-6241 Fax (773) 702-3171

Thanks for posting that Lena. I wonder if retching occurs with this procedure. I wonder what the potential side effects are compared to the L. Nissen. Perhaps when our kids are teens they will approve this for small children...LOL (sarcastically).

I wish there were more choices, this must be such a hard decision for you. :hug:

Thanks for posting that Lena. I wonder if retching occurs with this procedure. I wonder what the potential side effects are compared to the L. Nissen. Perhaps when our kids are teens they will approve this for small children...LOL (sarcastically).

I wish there were more choices, this must be such a hard decision for you. :hug:

I've read quite a few studies and the 'endotherapies' have little to no side effects post op. They have a much higher success rate than fundos do.

In the UK a colleague of our old GI does the endoscopic fundoplication, though mostly on older children, I think 5 years and above and according to our old GI the procedure is still highly experimental and a lot of people have not been happy with the results though the results get better results as the children get older.

The results getting better as they get older may be because it is easier to perform as they age because they aren't so small--I have heard the same thing from a fundo--the older they are the more successful it is. I know there is another reason but I cant think of what right now--it's too early.:coffee:

Although it is reported that there are lttle side effects and that people who have had it done are happy with it, I read similar results of fundoplications when considering Chelsea's first one. I read in study after study that the success rate of a fundo was at least 90 percent. The chance of it slipping in the first year was 1 percent. I knew adults and kids who had great results and were happy with it not even needing meds again.

We all know that didn't happen or Chelsea and Noah and Jackson and tons of other kids. The more info that is published now shows the opposite--that 62 percent are back at the GI's two months after surgery seeking medication treatment for GERD. Take in to consideration though that many kids still have positive results.

It makes me wonder if the success rate on these newer procedures will change significantly or not once they are done enough times over a long enough period of time.

If I had to go back in time, I still would have done it. I may have opted for a gtube to help with recovery at the very least, and would have gone into it with more realistic expectations. Her second one was more realistic of what the norm seems to be--for a little longer than a year she had relief from the symptoms that prompted us to do it--the asthma attacks, croup, and chronic sinus infections. But she still had pain and had some new problems. We have been able to manage these new problems so it was still a good choice to do it. Unfortunately, it didn't last as long as I hoped and she is on more meds now than before, because not only does she need treatment for the old problems but we are still treating the new ones. Can I say it was worth it for the year that she had no respiratory problems??????!

We were told the same thing about the fundo, the older the better.

Our surgeon just said that these others have not been tested long enough or seen long term results from the other procedures. They don't trust them enough to use them.