Hiatal Hernia Surgery: Everything You Need To Know
A hiatal hernia can be a source of discomfort and worry. It’s a condition in which part of the stomach pushes through the diaphragm into the chest cavity. This can lead to symptoms like heartburn, acid reflux and chest pain. For some, lifestyle changes and medication can manage the symptoms. For others, surgery may be the best option.
Hiatal hernia surgery aims to repair the hernia and alleviate symptoms. It’s a significant decision, which comes with potential risks and benefits of the surgery, including the possibility of weight loss post-surgery.
What is a Hiatal Hernia?
A hiatal hernia occurs when a part of your stomach pushes upward through your diaphragm. The diaphragm is a large muscle that separates the abdomen from the chest cavity. It has a small opening, the hiatus, through which your food tube (esophagus) passes before connecting to your stomach.
2 main types of hiatal hernias
- Sliding hiatal hernias are the most common type. They occur when your stomach and the part of the esophagus that joins your stomach slide up into your chest through the hiatus opening.
- Paraesophageal hernias are less common but can be more serious. The esophagus and stomach may be stable but part of the stomach squeezes through the hiatus, next to the esophagus.
While many people with a hiatal hernia have no symptoms, others may experience discomfort and complications. These can range from mild heartburn to severe chest pain and difficulty swallowing.
Symptoms and diagnosis of hiatal hernia
The most common signs of hiatal hernia include heartburn, acid reflux and chest pain. These symptoms are often worse after a meal, when lying down or when bending over. In some cases, surgery becomes necessary.
Diagnosing a hiatal hernia involves a series of tests that can include:
- An endoscopy, where a thin flexible tube with a light and camera is inserted to examine your esophagus and stomach.
- A barium swallow, where you swallow a liquid that coats your digestive tract and makes it visible on X-rays.
- Esophageal manometry, which measures the rhythmic muscle contractions in your esophagus when you swallow, the coordination and force exerted by the esophagus muscles, and how well your lower esophageal sphincter is working.
These tests help your doctor determine the size and type of your hiatal hernia, crucial for deciding the best treatment approach.
What causes a hiatal hernia?
The exact cause of a hiatal hernia is not always known. However, it is often associated with a weakening of the muscle tissue around the diaphragm due to age, injury or intense pressure on the surrounding muscles.
Certain factors can increase your risk of developing a hiatal hernia, including:
- Hiatal hernias are more common in people over 50.
- Extra weight puts pressure on your abdomen, pushing your stomach up into your chest cavity.
- Heavy lifting, straining or intense physical activity can put pressure on your abdomen.
When is hiatal hernia surgery needed?
Surgery for a hiatal hernia is not always the first line of treatment. Initially, doctors may recommend lifestyle changes and medications to manage symptoms. These can include dietary modifications and prescription medications to control acid reflux.
Surgery may be recommended in the following situations:
- When lifestyle changes and medications don’t provide relief.
- If the hernia is large or causes severe symptoms.
- In cases where the hernia is at risk of becoming strangulated (cutting off blood supply to the stomach).
Types of hiatal hernia procedures
There are two main types of hiatal hernia surgery: laparoscopic repair and open repair. Both procedures aim to reposition the stomach and tighten the diaphragm, but differ in their approach.The choice often depends on size and location of the hernia, the patient’s overall health and a surgeon’s expertise.
Laparoscopic repair is a minimally invasive procedure. It involves making small incisions in the abdomen through which surgical instruments are inserted. Laparoscopic repair is often the preferred method for hiatal hernia surgery. It’s less invasive than open repair, leading to less postoperative pain and a quicker recovery time. The procedure may also take longer than open repair.
Open repair involves a larger incision in the abdomen or chest. This allows the surgeon direct access to the hernia. Open repair is a more traditional surgical approach. It allows the surgeon a better view and more direct access to the hernia. It can involve a longer recovery period and higher risk of complications compared to laparoscopic repair.
Hiatal hernia surgery risks
Like any surgical procedure, hiatal hernia surgery carries certain risks. These can range from minor to severe, depending on various factors. Common risks include infection, bleeding and adverse reactions to anesthesia. There’s also a risk of injury to nearby organs during the procedure.
More specific to hiatal hernia surgery, patients may experience difficulty swallowing, known as dysphagia. This usually improves over time but can be a persistent issue for some. Despite these risks, complications are relatively rare. A skilled surgical team and thorough preoperative evaluation can significantly minimize these risks.
The recovery process after hiatal hernia surgery varies from person to person. It largely depends on the type of surgery performed and the patient’s overall health. Typically, patients can expect to stay in the hospital for 1-2 days post-surgery. During this time, pain management and monitoring for complications are the primary focus.
The Surgical Weight Control Center offers a Postoperative Diet Guide to discuss your nutrition needs after hiatal hernia surgery. Most patients can expect to fully recover within 3-6 weeks and it’s important to remember that everyone’s recovery timeline is unique.
Take Action: Next Steps After Hiatal Hernia Surgery
After hiatal hernia surgery, some patients may experience weight loss. This can be due to dietary changes and improved digestive function. Our experts say it’s important to maintain a healthy lifestyle post-surgery, including:
- Eating a balanced diet
- Regular physical activity
- Avoiding heavy lifting
- Regular follow-up appointments
Hiatal hernia surgery can significantly improve the quality of life for those suffering from this condition. It’s crucial to understand the procedure, its risks and the recovery process. Always consult with your healthcare provider to discuss your options. The team at the Surgical Weight Control Center is here to support and inspire you after weight-loss surgery.
Schedule an appointment
Discover if you’re a good candidate for hiatal hernia surgery by taking the health risk assessment. You may also reach us by completing the contact us form or calling 702-313-8446 for information.
Individual results may vary. There are risks associated with any surgical procedure. Talk with your doctor about these risks to find out if minimally invasive surgery is right for you.