Hiatal Hernia Repair
All of us have a small opening in the diaphragm known as the hiatus, which allows the esophagus to pass through. A hiatal hernia is the enlargement of the hiatus that allows the upper portion of stomach to push through the diaphragm. Most patients suffering from obesity have a hiatal hernia and these are typically identified and repaired as part of a primary bariatric surgery procedure for obesity, or during a Nissen fundoplication for the treatment of GERD or gastroesophageal reflux disease.
Symptoms of Hiatal Hernias
Typically, smaller hiatal hernias do not cause significant symptoms and most patients will not know that they have one. Further, most patients are not screened for a hiatal hernia unless they have severe and uncontrollable acid reflux. If symptoms do occur, they commonly manifest as a worsening in acid reflux. Larger hiatal hernias may be painful and patients may have difficulty swallowing.
Hiatal Hernia Surgery
Depending on the size of the hiatal hernia, it may be repaired using sutures or a hernia mesh similar to that used with an abdominal hernia. While most hiatal hernias are repaired secondarily to another procedure, virtually all hiatal hernia’s are repaired using laparoscopy – small incisions in the abdomen – versus open surgery. Ultimately, the goal is to stop the stomach from protruding through the diaphragm.
Hiatal hernia repair is relatively straightforward, and the typical recovery protocol after a primary bariatric surgery or Nissen fundoplication will apply. Hiatal hernia repairs are usually very successful.