The most serious complications of hernias are obstruction and strangulation.
A strangulated hernia can cause tissue death and this condition may be life-threatening if you don't get treatment right away.
It is also possible for hernias to rupture, which is an extremely rare possibility but should this situation arise, it demands surgery on an emergency basis.
Small hernias that go untreated tend to urge larger over time. If a hernia gets too big, it can cause swelling and pain in your abdomen and eventually cause a lot of discomforts.
Hiatal Hernia is a surgery where a patient's hiatal hernia is repaired by pulling the stomach back into the abdomen, as well as making the opening in the diaphragm smaller.
Depending on the condition of the patient, the procedure may also involve surgically removing hernia sacs or reconstructing the esophageal sphincter.
Hiatal hernia surgery is advised in cases where the other treatments are not well responsive and there is no distinct change. It is also advised when a patient is facing critical symptom because of your hernia including:
Narrowing of the esophagus.
The Hiatal hernia surgery can be performed in three ways –
Hiatal surgeries can be performed through open repairs, laparoscopic repairs, and endoluminal fundoplication.
All the surgeries are performed under general anesthesia and take about two to three hours to complete.
Laparoscopic Cruroplasty and Nissen fundoplication-
This is a procedure for the repair of a hiatal hernia. The repair will help prevent complications such as bleeding, strangulation, intestinal disruption, and the like.
Asymptomatic patients and ones with a sliding hernia are recommended an elective repair. The asymptomatic patients may be observed for symptoms and recommended for surgery if the symptoms arise.
The Laparoscopic Cruroplasty and Nissen Fundoplication surgery are carried out through five-quarter-inch incisions.
The camera and other tools are placed through these incisions. The hernia is then reduced from the chest into the abdomen. The procedure might also require the separation of abdominal organs from the lung and middle chest structures.
The hiatus is then re-assessed to its appropriate size. In some cases, the hernias are so large and tissues are so poor that there is a need to use prosthetic material to prevent their recurrence.
The Laparoscopic Hiatal Hernia procedure typically takes two to four hours, depending on the size and contents of the hernia. Patients are kept under observation in the hospital overnight and usually discharged the next afternoon.
Earlier open surgery was the only option for hiatal hernia repair.
This approach takes prolonged recovery time as well as performed through a large painful incision.
In this procedure, the surgeon pulls the stomach back into place and secures the esophagus with the stomach muscles.
The open surgical technique makes an 8-10-inch upper abdominal incision and therefore this surgery is more invasive than the laparoscopic repair.
Endoluminal fundoplication is the newest procedure, and the least invasive option so far. In this procedure, no incisions are made.
The surgeon will insert an endoscope with a lighted camera, through your mouth and down into the esophagus.
Then small clips are placed at the junction where the stomach meets the esophagus. These clips help prevent stomach acid and food from backing up into the esophagus.
Laparoscopic Cruroplasty and Nissen fundoplication:
Patients recover faster with laparoscopic Cruroplasty and Nissen Fundoplication. However, resuming normal activities may take around 2-7 days.
In the laparoscopic method, there are fewer chances of wound infections as well as a lower amount of pain as compared to open surgery. The most important factor of laparoscopic surgery is that more than 90% of patients are symptom-free even ten years after the procedure.
Recovery from Open Hiatal surgery:
Patients might experience tingling or burning pain near the site of the incision, but this feeling is temporary.
Post-surgery the incision wound should be kept clean and dry. The patient can shower but should avoid baths, pools, or hot tubs.
There will be restrictions on diet to prevent the stomach from bloating. Preferably liquid diets graduating to soft foods. The meals can be taken at smaller intervals instead of taking major meals, which patients might be habituated before the surgery.
Some breathing exercises will help you with coughing without causing much pressure on the wound as well as strengthening your diaphragm.
Hiatal Hernia is major surgery and a total recovery can take 10 to 12 weeks.
The patient can resume normal activities within 10 to 12 weeks. The patient can resume work in six to eight weeks unless the work is not very strenuous.
For very physically demanding jobs, the patient might take closer to a few months to resume work.
Post-surgery, it is best to avoid-
Drinking through a straw.
Foods that can cause gas.
Some complications can be serious and can even be life-threatening.
Infection on the wound (incision)
A blood clot in your leg
A blood clot in your lung
Specific complications of the Laparoscopic procedure-
• Injury or damage to adjacent organs such as your bowel, bladder, or blood vessels.
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