fundoplication and diaphragmatic cruroraphy for congenital diaphragmatic hernia


Winnie Tsu
 

Hi All,

Just wondering if anybody has helped somebody who has had the above surgery.  

I had somebody read something I wrote on the phrenic nerve and ask me about her symptoms post the above surgeries.

I figure working on what we find with listening would be where to start....but any feedback on prognosis with our type of treatments?  

Also the person wants to know if they should have another cruroraphy

Winnie VAlencia
CS1-2, SER 1, 2, VM 1-6, NM 1-4


drmariotti@...
 

Hi Winnie;

 

Working with a patient with a fundoplication procedure can be very difficult. Obviously, you're not going to change the course of the surgery. However, you can improve the functionality of the stomach. I would advise staying away from the stomach itself after they have had this procedure. Unless you're only wanting to work with motility and the sphincters. Of course, you may get a listening that takes you to the stomach. But working on this stomach, after a procedure such as this can be dangerous for the patient and let's be honest, you were the lowest hanging fruit, and so you're likely to be the one who is blamed if there are any problems. Best to stay away from the stomach and work with the tissues around it. Since you have already had VM4 I would recommend working on the thoracic organs and the cervical fascia, which will help to normalize cavitary pressures. You may also want to consider working with the duodenum. Progress will likely be slow. But you can still be of some benefit. With patient's like this the most important factor is to stay humble. If you can help… Wonderful but they have had a significant surgery and this will obviously play a part.

 

Ron


Winnie Tsu
 

thanks Ron.  She is in Tiblisi Georgia so i won’t be working on her as i am
in Canada.  Do you know of any good therapists in the area?  also,  she wants to know if she should go through another diaphragmatic  cruroraphy that her doctors recommended…any thoughts on this?

Winnie


On Jun 24, 2021, at 9:16 PM, drmariotti via groups.io <drmariotti@...> wrote:



Hi Winnie;

 

Working with a patient with a fundoplication procedure can be very difficult. Obviously, you're not going to change the course of the surgery. However, you can improve the functionality of the stomach. I would advise staying away from the stomach itself after they have had this procedure. Unless you're only wanting to work with motility and the sphincters. Of course, you may get a listening that takes you to the stomach. But working on this stomach, after a procedure such as this can be dangerous for the patient and let's be honest, you were the lowest hanging fruit, and so you're likely to be the one who is blamed if there are any problems. Best to stay away from the stomach and work with the tissues around it. Since you have already had VM4 I would recommend working on the thoracic organs and the cervical fascia, which will help to normalize cavitary pressures. You may also want to consider working with the duodenum. Progress will likely be slow. But you can still be of some benefit. With patient's like this the most important factor is to stay humble. If you can help… Wonderful but they have had a significant surgery and this will obviously play a part.

 

Ron