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Hiatus Hernia Repair

Hiatus hernia occurs when a portion of the stomach pushes through the diaphragm through a tiny orifice called the hiatus. Hiatus hernias are often unnoticed for quite a long period of time. As the condition becomes worse, signs like heartburn, chest pain, severe acid reflux etc may be experienced. The risk for hiatus hernias in especially large for chain smokers, obese people etc. Sensation of nausea may also be felt. Certain cases of hiatus hernias can be treated using medications, changes in lifestyle etc. However, other types of hiatus hernia require surgery.

In open surgical method, the surgeon makes an open cut in the abdominal area. In order to maintain the stomach position, the surgeon sometimes places a tube from the stomach.

In the laparoscopic surgical method, a couple of incisions are made by the surgeon on both hernia sides. One incision is used for inserting the laparoscope and the other for inserting the instruments. The defect in the diaphragm is detected. The stomach is then pulled back and its topmost portion is wrapped around the esophageal end. Appropriate staples or stitches are used for accomplishing this task. A recovery time for almost 2 weeks is necessary. During this period, care should be taken so that maximum protection is given to the incision. Some of the activities that should be given concern are:

  • Coughing & sneezing.
  • Vomiting.
  • Applying force for a downward bowel movement.
  • Sudden movement from a sedentary position.

Another surgical procedure called fundoplication is needed when hiatus hernias become severe. Chronic acid reflux may be involved in these cases. This condition can seriously injure the food pipe.

The upper portion of the stomach, called as gastric fundus, is wrapped tightly. Wrapping is performed around the inferior part of the food pipe. The herniation of the stomach is thus prevented. The reflux brought out by the gastric acid is also brought under control. The general advantages of laparoscopic techniques can be applied. These include less post-operative pain, less time for recovery, less number of scars etc.

Complications are rare, and if present shall include dumping syndrome, dysphagia, gas bloat syndrome etc.