Hiatal Hernia Repair

The hiatus is the "flap" that controls the pressure change from the esophagus to the stomach.

When a portion of the stomach pushes up through the hiatus and rests next to the esophagus, this can cause a number of symptoms including heartburn, chest pain, and gastroesophageal reflux disease, or GERD.

In severe cases, this hernia can cause a "strangulation" of the stomach, cutting off blood flow.

What causes frequent heartburn?

Recently, the New England Journal of Medicine reported that over 40 percent of all Americans suffer from some sort of heartburn at least once a month.

Frequent heartburn can be a symptom of a much more serious condition known as gastroesophageal reflux, or GERD.

Typical symptoms of GERD include painful heartburn, indigestion, regurgitation, difficulty sleeping, hoarseness, and sore throat.

GERD occurs when acid from the stomach surges upward into the esophagus. The result is painful and frequent heartburn or acid reflux.

In functioning anatomy, the hiatus, a valve at the end of the esophagus, keeps the acidic gastric liquids from rising up into the esophagus. It is when this valve is malfunctioning that reflux occurs.

The valve defect may be congenital from birth, or it may have become weakened as part of the normal aging process.

Although most cases of reflux are caused by this weakened valve, there are other causes that need to be evaluated and treated by your doctor.


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Gastroesophageal reflux disease

GERD is a common gastrointestinal disorder that affects about 20% of Americans. While occasional heartburn is normal, frequent and untreated GERD can lead to a range of serious complications. Learn more about the symptoms and treatments of GERD.

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What is a Hiatal Hernia?

Other patients may suffer from what is known as a hiatal hernia.

A hiatal hernia is caused by an opening in the diaphragm, which is a flat muscle that separates the lungs from the abdomen.

When the opening in the diaphragm enlarges, a portion of the lower esophagus, and in some cases, the stomach itself herniates or pushes into the opening.

Stress, heavy lifting, pregnancy, and the normal wear and tear of life on the body can cause a hiatal hernia.

If untreated, hiatal hernias can cause ulceration of the esophagus, narrowing of the esophagus, difficulty in swallowing, respiratory problems, and possibly even esophageal cancer.

Treatments for Hiatal Hernia

While medical therapies can help reduce symptoms, the basic abnormality of the malfunctioning valve is not addressed in traditional therapies.

Here's the good news: thanks to minimally invasive surgery, chronic heartburn can be cured in many cases.

In this safe and highly effective procedure, the surgeon wraps a part of the stomach known as the gastric fundus around the lower esophagus.

This lengthens the lower esophageal sphincter and improves the performance of the sphincter, preventing the flow of acids from the stomach into the esophagus and eliminating heartburn.

Minimally Invasive Hiatal Hernia Repair Surgery

With traditional open surgery, a large seven to ten-inch incision must be made.

Because this cuts across muscle tissue, there can be significant post-operative pain and infection in and around the incision can also occur.

A large scar will be visible following the operation, and a lengthy recovery from six to eight weeks is possible.

With minimally invasive surgery, one small incision is made for a fiber optic camera, which allows the surgeon to view the anatomy of the procedure.

Three to five additional small incisions are then made for other surgical instruments to be inserted into the abdominal cavity to perform the surgery.

Post-operative pain is significantly reduced because the small incisions do not cut across large tissue areas.

Recovery from Hiatal Hernia Repair Surgery

Following the operation, the surgeon will place one or two stitches in each of the access points. Because of the minimally invasive nature of the procedure, scarring is significantly reduced.

Patients who choose minimally invasive surgery over open surgery usually stay in the hospital for one to three days instead of the one-week period required with open surgery.

In many cases, recovery time can be as little as two weeks compared with six to eight weeks with open surgery.

Risks and Complications

Potential risks and complications of the minimally invasive procedure are similar to those associated with open surgery, such as reactions to anesthesia and medications, and a minor risk of bleeding and infection.

There may also be some slight discomfort in swallowing, belching, or vomiting. It's recommended that you stick with liquid or soft foods for a few days after surgery to alleviate these issues.

If you think you may have a hiatal hernia, talk with your doctor about your options.

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