To: vocalist
Subject: Re: Singer with Hiatal Hernia
Date sent: Sun, 19 Dec 1999 00:26:49 EST
Send reply to: VOCALIST <vocalist>

>She has been advised to have surgery and is
>concerned about possible effect on her ability to sing. >
>2. Would a medical professional care to comment on the different procedures
>and any effect on her ability to sing?
>
The newest procedure is an endoscopic variation of the old Nissen
fundoplication. It seems to have a fairly good success rate, but it is
still surgery.

A few small incisions are made in the abdomen and a tube device is used to
manipulate the stomach up to fold over the lower esophagus increasing the
external pressure. This replaces the pressure the diaphragm is supposed to
put on it to keep the stomach contents down.

If she has it done, she should go to someone who has been doing it a long
time (the procedure is only about 6-7 years old). It can be made too tight,
making swallowing a problem. Assuming a decent result, it can help the
voice by reducing or eliminating reflux.

The usual caveats about surgery for singers apply.

John

John Messmer, MD, Assistant Professor, Family & Community Medicine; Medical
Director, Penn State Geisinger Health Group, Palmyra, PA

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