Hiatal hernia repair

Definition

Hiatal hernia repair is surgery to correct a defect in the diaphragm, the breathing muscle that separates the chest area from the stomach area.

Alternative Names

Fundoplication; Anti-reflux surgery

Indications

Hiatal hernia repair may be recommended when the patient has some of these symptoms:

  • Severe heartburn
  • Severe inflammation of the esophagus due to the backflow of gastric fluids (reflux)
  • Narrowing of the esophagus due to acid damage (esophageal stricture)
  • Chronic inflammation of the lungs (pneumonia) due to frequent breathing in (aspiration) of gastric fluids
  • A hiatal hernia that raises the risk of the stomach getting stuck in the chest or twisting on itself (para-esophageal hernia)

Convalescence

Patients who have laparoscopic surgery typically spend 1 to 3 days in hospital. Those who have open surgery may spent 2 to 6 days in the hospital after the procedure.

During surgery, a tube was placed into the stomach through the nose and throat (nasogastric tube). Some surgeons like to leave the tube in for a few days after the procedure, while others do not.

Eat small, frequent meals after the surgery and avoid gas-producing foods.

Most patients go back to work in 2-3 weeks for laparoscopic surgery, or 4-6 weeks after open surgery.

Expectations after surgery

Hiatal hernia repair is a safe, effective operation. Reflux is greatly reduced or eliminated in 95% of patients.

Risks

Risks specific to this surgery include:

  • Gas bloat, which causes difficulty burping or vomiting and results in bloating after meals. This occurs in about 40% of cases but gradually improves in most patients. In rare cases, the bloating is long term.
  • Pain with swallowing (dysphagia) occurs in 5 - 40% of patients, but improves over the first 3 months in almost all patients.
  • Damage to the stomach or esophagus (rare)
  • Recurrence of the hiatal hernia

Risks for any anesthesia include the following:

Risks for any surgery include the following:

  • Bleeding
  • Infection
Hiatal hernia - X-ray
Hiatal hernia - X-ray
Hiatal hernia repair - series
Hiatal hernia repair - series
Review Date: 7/7/2006
Reviewed By: J.A. Lee, M.D., Division of Surgery, UCSF, San Francisco, CA. Review provided by VeriMed Healthcare Network.
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