A hiatal hernia is a condition in which part of the stomach pushes up through an opening in the diaphragm. This can cause heartburn, acid reflux, and other symptoms. If you are experiencing these symptoms, you may be a candidate for hiatal hernia surgery.
This blog post will provide you with an overview of hiatal hernia surgery, including the different types of surgery. By the end of this post, you will have a better understanding of hiatal hernia surgery and whether or not it is the right option for you.
What Is Hiatal Hernia Surgery?
Hiatal hernia repair is a procedure to repair the hole in the diaphragm and tighten the muscle around the opening, preventing the stomach from bulging up into the chest. This surgery is done to treat a hiatal hernia, which is a condition where the upper part of the stomach bulges through a weak spot in the diaphragm. When this happens, stomach acid can flow back into the esophagus, causing heartburn, acid reflux, and other symptoms.
Hiatal hernia repair can be done through a small incision in the abdomen (laparoscopic surgery) or a larger incision in the chest (open surgery). The surgery is typically successful in relieving symptoms and preventing the recurrence of the hernia.
What Types of Hiatal Hernia Surgery Are There?
The type of hiatal hernia surgery performed is determined by the type of hernia and the patient’s condition. The most popular hiatal hernia surgeries include laparoscopic Nissen fundoplication, laparoscopic Toupet fundoplication, and laparoscopic correction of paraesophageal hernia. Let’s look at these in detail:-
Laparoscopic Nissen Fundoplication
A Laparoscopic Nissen fundoplication is a surgical procedure that includes encircling the upper portion of the stomach around the lower esophageal sphincter, effectively inhibiting acid reflux. This surgical technique is used to ease the symptoms associated with gastroesophageal reflux disease (GERD) by reinforcing the barrier between the stomach and the oesophagus.
Toupet Fundoplication
This is a surgical procedure that is similar to the Nissen fundoplication. However, it differs in the sense that it involves wrapping only the posterior section of the stomach around the oesophagus.
Laparoscopic Repair of Paraesophageal Hernia
Laparoscopic repair of a paraesophageal hernia entails the repositioning of the stomach to its natural state and the subsequent mending of the diaphragm muscle.
What is the Purpose of Hiatal Hernia Surgery?
Hiatal hernia surgery is performed to provide relief from distressing symptoms such as heartburn, regurgitation, and chest pain. The purpose of hiatal hernia surgery extends beyond symptom relief and complication management. It aims to improve the overall quality of life for individuals suffering from this condition. By reducing discomfort and enhancing digestion, the surgery allows patients to regain control over their daily activities and enjoy a better quality of life.
How Can You Prepare Yourself for Hiatal Hernia Surgery?
Before undergoing a hiatal hernia surgery, it is essential to adequately prepare yourself. Here are some important guidelines to ensure you are well-prepared for the procedure:
- Consultation: It is imperative to schedule a consultation with a highly qualified surgeon who specialises in treating hiatal hernias. During this consultation, the surgeon will thoroughly assess your condition, discuss various surgical options available, and address any concerns or questions you may have about the procedure.
- Medical Evaluation: To ensure your fitness for surgery, your surgeon will require a comprehensive medical evaluation. This evaluation may involve a series of tests, imaging procedures, and other diagnostic measures to assess your overall health and identify any potential risks.
- Medication Management: In the days before the procedure, your surgeon may or may not advise you to change or stop taking any medication you are already taking. This precaution is done to reduce potential difficulties during or after the treatment.
- Dietary Restrictions: Your surgeon may recommend specific dietary guidelines or fasting instructions to follow before the surgery. Adhering to these recommendations is crucial as it helps minimise the risk of complications during the surgical process.
- Smoking and Alcohol: If you are a smoker or consume alcohol, it is highly advisable to quit or reduce these habits before the surgery. Smoking and alcohol consumption can significantly interfere with the healing process, so it is essential to follow your surgeon’s advice in this regard.
It is important to note that the above list provides a general overview of the necessary preparations before undergoing hiatal hernia surgery. Your surgeon will provide you with a thorough list of dos and don’ts specific to your situation. By following these guidelines, you can ensure a smoother and more successful hiatal hernia procedure.
How Is Hiatal Hernia Surgery Performed?
The surgical approach to hiatal hernia repair depends on the type of surgery chosen. Here is an overview of the general process:
- Anaesthesia: You will be given general anaesthesia to ensure you are unconscious and pain-free during the surgery.
- Incisions: For laparoscopic surgery, small incisions are made in the abdomen to access the hernia site. In open repair, a larger incision is made.
- Hernia Reduction: The surgeon carefully returns the herniated organs to their correct position below the diaphragm.
- Hernia Repair: The surgeon reinforces the weakened hiatus with stitches or mesh material to prevent future herniation.
- Wrapping the Stomach: In some procedures, the top part of the stomach is wrapped around the lower oesophagus to create a stronger barrier against reflux.
- Closing The Incisions: Once the repair is complete, the incisions are closed, and you are taken to a recovery area.
How to Know If You Need Surgery for a Hiatal Hernia?
Not all hiatal hernias require surgery, as treatment decisions depend on the severity of your symptoms and the risk of complications. Surgery is typically considered in the following situations:
- Severe symptoms that do not respond to conservative treatments like dietary changes and medication.
- Complications like Barrett’s oesophagus or recurrent pneumonia.
- Large hiatal hernias that are at risk of becoming incarcerated or strangulated.
- Failed previous attempts at non-surgical management.
Who Benefits from Hiatal Hernia Repair Surgery?
Hiatal hernia repair surgery can benefit individuals who are struggling with the symptoms and complications of this condition. It offers the following advantages:
- Symptom Relief: Surgery can significantly reduce or eliminate symptoms like heartburn, regurgitation, chest pain, and difficulty swallowing.
- Complication Prevention: By repairing the hernia, surgery helps prevent complications such as esophagitis, Barrett’s oesophagus, and aspiration pneumonia.
- Improved Quality of Life: Patients often experience an improved overall quality of life, with better digestion and reduced discomfort.
Conclusion
Hiatal hernia surgery is a viable option for individuals with symptomatic hiatal hernias that don’t respond to conservative treatments. Understanding the types of surgery, its purpose, and how to prepare for it is essential for making informed decisions about your health. If you suspect you have a hiatal hernia or have been diagnosed with one, consult a qualified surgeon to discuss the best course of action for your specific case. Your journey to relief and improved well-being may begin with this surgical intervention.
FAQs
1. How Serious is Surgery to Repair a Hiatal Hernia?
In general, a hiatal hernia surgery is widely regarded as a risk-free and effective operation. However, the severity of the surgery depends on the individual’s overall health and the type of surgery performed. It is also important to note that just like with any surgery, there are risks and complications to consider, which your surgeon will go over with you. Hence, it is critical to contact your healthcare physician thoroughly to understand the unique risks and benefits in your instance.
2. What are the precautions after hiatal hernia surgery?
After hiatal hernia surgery, it’s important to follow your surgeon’s instructions carefully to ensure a smooth recovery. Some common precautions may include:
Diet: You may be advised to follow a special diet, initially consisting of liquids and soft foods, and gradually transitioning to a regular diet.
Activity: Avoid heavy lifting and strenuous activities for a specified period as advised by your surgeon.
Medications: Take prescribed medications as directed, including pain relievers and any medications to reduce acid reflux if needed.
Wound care: Keep the surgical incision clean and dry, following any dressing changes recommended by your healthcare provider.
Follow-up appointments: Attend all follow-up appointments to monitor your progress and address any concerns.
Reflux precautions: Continue any lifestyle modifications to manage acid reflux, as advised by your healthcare provider.
3. How long does it take to recover from hiatal hernia surgery?
Recovery time can vary from person to person and depends on the type of surgery performed. In general, most people can return to their normal activities within a few weeks to a couple of months after hiatal hernia surgery. However, it’s important to note that full recovery may take several months to a year.
During the initial weeks after surgery, you may experience some discomfort and dietary restrictions. It’s essential to follow your surgeon’s advice on activity levels and dietary choices during this period.
Your healthcare provider will provide you with a more specific timeline for your recovery based on your individual circumstances and the type of surgery you underwent. Regular follow-up appointments will also help monitor your progress and address any concerns that may arise during your hiatal hernia recovery.
References
https://www.ncbi.nlm.nih.gov/books/NBK562200/
https://www.med.umich.edu/1libr/Surgery/ThoracicSurgery/HiatalHerniaRepair.pdf
https://www.medicalnewstoday.com/articles/321370#types-of-surgery
