Hiatal Hernia Surgery

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Definition

What is Hiatal Hernia Surgery?

A hiatal hernia occurs when part of the stomach moves upwards into the chest. Hiatal hernia surgery is a surgical procedure to correct hiatal hernias.

The purpose of hiatal hernia surgery is to to reduce the hernia, meaning put it back where it belongs.

When is Hiatal Hernia Surgery needed?

Most hiatal hernias do not cause symptoms, and therefore treatment is not usually necessary. Those who have mild symptoms, such as heartburn, acid reflux, or gastroesophageal reflux disorder (GERD) may be able to treat their condition with medications or lifestyle changes.

However, surgery may be recommended if:

  • Symptoms are severe and interfere with quality of life
  • Symptoms do not respond to other treatments
  • The hernia is at risk of becoming strangulated, which is where the blood supply to the herniated tissue is cut off — a situation that can be fatal
  • Symptoms include bleeding, ulcers, or narrowing of the food pipe (esophagus), which is known as an esophageal stricture

Precautions

What should you know before undergoing Hiatal Hernia Surgery?

Not everyone who has a hiatal hernia needs surgery. Surgery is typically reserved for people with severe cases that haven’t responded well to other treatments.

What are the complications and side effects?

Possible complications that could arise from hiatal hernia surgery include:

  • Infection
  • Bleeding
  • Injury to the neighboring structures
  • Anesthetic complications
  • Need for further procedures
  • Pneumonia
  • Blood clot formation
  • Heart problems
  • Difficulty swallowing because the stomach is wrapped too high on the esophagus, or is wrapped too tightly
  • The esophagus sliding out of the wrapped portion of the stomach so that the valve (lower esophageal sphincter) is no longer supported
  • Heartburn that recurs

After laparoscopic surgery, most people will not experience much pain, but they may feel discomfort in their abdomen and chest and have difficulty swallowing. This usually passes within 48 hours.

Many people experience tingling or burning pain near the site of the incision, but this feeling is temporary. It can be treated with NSAIDs, including over-the-counter options like ibuprofen (Motrin).

It is important you understand the precautions and know the possible complication and side effects before having this Hiatal Hernia Surgery. If you have any questions, please consult with your doctor or surgeon for more information.

Process

How do I prepare for Hiatal Hernia Surgery?

Your doctor will give you all the information you need about how to prepare for your surgery. Preparation generally includes:

  • Walking 3 to 4 km per day
  • Doing several breathing exercises multiple times per day
  • Not smoking for 4 weeks before the surgery
  • Not taking clopidogrel (plavix) for at least one week before surgery
  • Not taking nonsteroidal anti-inflammatories (NSAIDs) one week before surgery

Typically, a clear liquid diet is not needed for this surgery. However, you can’t eat or drink for at least 12 hours before the surgery.

What happens during Hiatal Hernia Surgery?

The procedure may take up to 3 hours. After a laparoscopy, you may be able to go home the same day if you have recovered from the anesthetic. Otherwise, you may spend a night in the hospital and should be able to walk around the day after the surgery.

Hiatal surgeries can be done with open repairs, laparoscopic repairs, and endoluminal fundoplication.

Open repair

This surgery is more invasive than the laparoscopic repair. During this procedure, your surgeon will make one large surgical incision in the abdomen. Then, they’ll pull the stomach back into place and manually wrap it around the lower portion of the esophagus to create a tighter sphincter. Your doctor may need to insert a tube into your stomach to keep it in place. If so, the tube will need to be removed in 2 to 4 weeks.

Laparoscopic repair

In a laparoscopic repair, recovery is quicker and there’s less risk of infection because the procedure is less invasive. Your surgeon will make 3 to 5 tiny incisions in the abdomen. They’ll insert the surgical instruments through these incisions. Guided by the laparoscope, which transmits images of the internal organs to a monitor, your doctor will pull the stomach back into the abdominal cavity where it belongs. Then they will wrap the upper part of the stomach around the lower portion of the esophagus, which creates a tighter sphincter to keep reflux from occurring.

Endoluminal fundoplication

Endoluminal fundoplication is a newer procedure, and it’s the least invasive option. No incisions will be made. Instead, your surgeon will insert an endoscope, which has a lighted camera, through your mouth and down into the esophagus. Then they’ll place small clips at the point where the stomach meets the esophagus. These clips can help prevent stomach acid and food from backing up into the esophagus.

What happens after Hiatal Hernia Surgery?

After surgery, you need to wash the incision area gently with soap and water daily. Avoid baths, pools, or hot tubs, and stick to the shower only. You’ll also have a restricted diet meant to prevent the stomach from extending. It involves eating 4 to 6 small meals per day instead of 3 large ones. You typically start on a liquid diet, and then gradually move to soft foods like mashed potatoes and scrambled eggs.

During your recovery, you’re given medication that you should only take with food.

If you have any questions or concerns, please consult with your doctor or surgeon for more information.

Recovery

What should you do after Hiatal Hernia Surgery?

You’ll need to avoid:

  • Drinking through a straw
  • Foods that can cause gas, such as corn, beans, cabbage, and cauliflower
  • Carbonated drinks
  • Alcohol
  • Citrus
  • Tomato products

You doctor will likely give you breathing and coughing exercises to help strengthen the diaphragm. You should perform these daily, or according to your doctor’s instruction.

As soon as you’re able, you should walk regularly to prevent blood clots from forming in your legs.

Because this is a major surgery, a full recovery can take 10 to 12 weeks. That being said, you can resume normal activities sooner than 10 to 12 weeks.

For example, you can start driving again as soon as you’re off narcotic pain medication. As long as your job isn’t physically strenuous, you can resume work in about 6 to 8 weeks. For more physically demanding jobs that require a lot of hard labor, it may be closer to three months before you can return.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: September 14, 2018 | Last Modified: September 14, 2018

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