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Procedure Name

Laparoscopic Hiatal Hernia Repair Surgery
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Surgery Type

Minimally Invasive
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Hospital Stay

1-2 days
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Duration of Surgery

2-3 hours
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Type of Anaesthesia

General Anesthesia
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Full Recovery

10-12 weeks

Overview

You may have heard of a hernia often, but what is a hiatal hernia? And how do you go about treating it? 

A hiatal hernia is a condition in which the top part of the stomach bulges upward through an opening in the diaphragm. The diaphragm is the membrane in your abdomen that separates abdominal organs from the heart and lungs in the chest cavity. Hiatal hernia is a common condition affecting the gastrointestinal tract. It is more common in women than in men. Several treatment options are available for hiatal hernia, with surgery being considered only for severe cases that have not responded well to other treatment modalities.

Here in this article, we will have a detailed look at hiatal hernia and one of its most popular surgery options, laparoscopic hiatal hernia repair. Read on to learn more.

What Is Hiatal Hernia?

A hiatal hernia is a medical condition in which the top part of the stomach protrudes upwards from the diaphragm opening into the chest. 

The esophagus, or food pipe, is an organ that carries food from your mouth to the stomach for digestion. The esophagus travels through a gap in your diaphragm known as the hiatus. When a part of your stomach pushes through this gap into your chest, it is known as a hiatal hernia. 

Any age and gender can be affected by hiatal hernia, but it is most commonly observed in people who are 50 or older. There are two types of hiatal hernia:

  • Sliding hiatal hernia: A part of your stomach and the lower part of your esophagus push (or slide) through your diaphragm into your chest, and can slide back and forth into the abdominal cavity. It is the most common type of hiatal hernia.
  • Paraesophageal or fixed hiatal hernia: This is a more serious condition when a part of your stomach pushes through your diaphragm and stays there alongside the esophagus (fixes itself).

What causes a hiatal hernia is not exactly clear. However, it is suggested that pressure on the diaphragm, the risk of which may be higher in some people due to certain genetic factors is the major cause. These risk factors include an age above 50, obesity, pregnancy, injury to the diaphragm, surgical procedures involving the food pipe, and an upward force that may occur due to weightlifting, straining for bowel movement, persistent coughing, or vomiting. 

How Is Hiatal Hernia Treated?

Hiatal hernias can be asymptomatic and, most of the time, are left untreated as they cause no problems or complications for the individual. When a hiatal hernia is symptomatic, it is often in the form of heartburn, a burning sensation around the lower chest area as a result of acid moving up from the stomach. 

If a hiatal hernia is symptomatic and getting bigger, it is advised to consult a doctor immediately. Different methods exist to treat hiatal hernias depending on their size, severity, and symptoms. 

Medications: You could require medication if you develop signs and symptoms like persistent heartburn and acid reflux.

Surgery: Severe cases of hiatal hernia that cause distressing symptoms and disrupt your health may need surgery. Surgery is often reserved for those who have not found relief from heartburn and acid reflux medications, witnessed severe complications or an increase in the size of the hernia, or are dealing with severe inflammation or esophageal narrowing.

Among the surgical options for treating hiatal hernia, laparoscopic hiatal hernia repair surgery is the most commonly used and popular option. It is a minimally invasive procedure that is performed through keyhole incisions and results in negligible bleeding. 

In this article, we will learn more about laparoscopic hiatal hernia repair surgery.

What is Laparoscopic Hiatal Hernia Repair Surgery?

Laparoscopic hiatal hernia repair surgery, is a minimally invasive surgical procedure to treat hiatal hernias. It is also known as laparoscopic Nissen fundoplication. 

As the name suggests, during a laparoscopic procedure, the surgeon makes several small incisions in the abdomen instead of a large incision. A laparoscope, which is a long, thin tube with a camera and light source at one end, is inserted through one of the incisions. It allows the surgeon to visualize the hernia on a monitor. Surgical tools are inserted through the other small incisions, which allow the surgeon to pull out the herniated portion of the stomach back into the abdominal cavity and repair the hiatus. 

The other name for the surgery, laparoscopic Nissen fundoplication, suggests that the surgery involves wrapping the upper part of the stomach (called the fundus) around the lower esophagus. This creates a tighter sphincter and prevents the acid reflux from occurring.

How Does Laparoscopic Hiatal Hernia Repair Surgery Work?

What Happens Before the Surgery? 

  • Your surgeon will discuss the procedure with you in detail so that you understand the pros and cons clearly. This will help prepare you physically and mentally for the procedure.
  • Your doctor will discuss your medical history, which includes your symptoms, other ailments, and current medications or supplements if you are taking any.
  • You might be asked to stop certain medications, such as blood thinners, for a brief period before and after the procedure in order to avoid complications such as excessive bleeding.
  • Make sure you inform your doctor if you have any allergies, such as to latex or any medications.
  • If you are a smoker, you will be asked to quit smoking for a certain period before and after the surgery, as it can delay healing. 
  • As part of preparing yourself for the surgery, and improving your health, you may be asked to walk 3 to 5 km every day and perform breathing exercises multiple times throughout the day. 
  • The doctor may perform a complete physical examination to assess your health and ask you to undergo certain blood and imaging tests to confirm the diagnosis.
  • The doctor may also order certain tests to examine your stomach and esophagus. These tests include the barium swallow test, esophageal manometry, upper endoscopy, and a pH probe. 
  • Make sure you arrange for a friend or a family member to help on the day of surgery and during your recovery.
  • You will be asked not to eat or drink anything for at least 8 to 12 hours prior to the surgery. 

What Happens During the Surgery? 

  • You are taken to the operating room and given a surgical gown to wear.
  • You are made to lie on the operating table. An intravenous (IV) line is placed on your arm for fluids and medications.
  • The surgical site is thoroughly cleaned with an antiseptic solution to remove surface contaminants.
  • This surgery is performed under general anesthesia, which will completely sedate you. Hence, you will not feel any pain or discomfort during the surgery.
  • The surgeon inflates your abdominal cavity with carbon dioxide so that they can visualize the internal anatomy of the abdominal cavity clearly.
  • Next, they make 4-6 small incisions in the abdomen above the navel and insert a laparoscope through an incision. The laparoscope transmits images of the internal organs to a monitor and guides the surgeon to the hernia. 
  • The surgeon inserts surgical instruments through the other incisions and pushes back the herniated stomach to its original position in the abdominal cavity. 
  • The surgeon also wraps the upper part of the stomach around the lower portion of the esophagus, to create a tighter sphincter.
  • The space within the muscular wall is then closed with the help of sutures.  In the end, a synthetic mesh may be placed within the abdominal wall to strengthen and stabilize it.
  • The incisions are closed with sutures (stitches) and covered with a waterproof surgical dressing.

 What Happens After the Surgery?

After a laparoscopic hiatal hernia repair, the following is expected:

  • You will be kept in the recovery room for an hour or two until you regain consciousness.
  • Your vital signs, such as blood pressure (BP), blood sugar, and pulse, will be constantly tracked.
  • The surgeon will encourage you to start walking on the same day, as it helps improve blood circulation and promotes healing. Walking can also help prevent the formation of blood clots.
  • Depending on your condition and if your doctor suspects some complications, you may need to spend one or two days in the hospital.
  • During the initial days following the surgery, you will probably have mild discomfort, bruising, and swelling close to the surgical site. To deal with these, your doctor may prescribe some medication including painkillers. You may also have difficulty swallowing for a short time after the surgery.
  • The doctor may advise the following during the recovery period:
    •  Follow a healthy and simple diet as soon as you get home. For a few weeks, avoid having fried, spicy, gassy, and citrus foods, as well as alcohol and caffeinated beverages.
    • Avoid wetting the surgical site until it has healed completely. 
    • Wash the incision area every day with plain soap and water. Opt for showers instead of baths. 
    • Avoid drinking through a straw.
    • Practice breathing and coughing exercises to increase the strength of the diaphragm.
    • Steer clear of heavy lifting for 2–3 weeks.
    • Resume driving only after 7–10 days of the surgery. 
  • You should be able to work within 2–3 weeks of the surgery.
  • Complete recovery may take between 10-12 weeks. 

What Are The Benefits Associated With Laparoscopic Hiatal Hernia Repair Surgery?

Compared to an open surgery, laparoscopic hiatal hernia repair surgery offers several advantages: 

  • Smaller incisions and lesser scarring
  • Less risk of infection
  • Reduced pain
  • Shorter hospital stay
  • Faster recovery
  • Fewer risk of complications

Are There Any Risks Associated With Laparoscopic Hiatal Hernia Repair Surgery?

The risks associated with laparoscopic hiatal hernia repair are:

  • Infection: As with every surgical procedure, there is a chance of infection developing at the surgical site.
  • Bleeding: Bleeding can occur both during and after surgery. In most circumstances, any bleeding that occurs during the surgery may be managed, but in rare cases, additional intervention may be necessary to handle severe bleeding.
  • Pulmonary aspiration: In the rare case of a large hiatal hernia, pulmonary aspiration can be a potential complication as, after the surgery, the stomach contents have moved up into your esophagus and one or both of your lungs. This can cause problems with breathing and swallowing. 
  • Injury to the surrounding organs: The surgery can cause injury to or bleeding in the surrounding tissues or nearby organs.
  • Allergic reactions to anesthesia: Allergies due to anesthesia may cause dizziness, vomiting, hives, rashes, and shortness of breath.
  • Post-operative complications: Post-operative complications include the inability to swallow or continued acid reflux, acidity, vomiting, and nausea.

Why Choose Medfin?

Surgery can be a daunting aspect, and feeling anxious is absolutely normal. The massive amount of information you can get from the internet may confuse you even more. This is where Medfin can help. Leave us the hefty task of finding the best hospital, the finest doctor, and the latest procedure at the lowest cost. Let us take charge while you sit back and focus on your health and recovery. Think surgery! Think Medfin! 

The power of Medfin in patient’s words

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“ Got to know about them from my friend. They got an appointment for only 299. Once the doctor confirmed that I needed the surgery they got me a fixed cost which included ALL the costs. No extra amounts were charged. Thank you Medfin”

Suresh Menon Hyderabad 8 days ago
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“ After my consultation with the doctor, MEDFIN representative got me a fixed package cost that included my mothers initial tests, surgery cost. They also gave me stockings free for Rs. 3000 post the surgery. They kept up their promise they made”

Radhika Iyer Mumbai 8 days ago
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“ Thank you Medfin. They ensured the whole process from selecting a very experienced doctor to offering the latest procedure at a very reasonable price. They also arranged a follow up post my surgery with the doctor to ensure my recovery was on track. Thank you for being there throughout”

Deepa Shree Bangalore 8 days ago
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