Our Summary

This study looked at the safety and effectiveness of a combined surgical procedure for treating a type of hernia known as giant paraoesophageal hernia. The procedure combines a method called transoral incisionless fundoplication (TIF) with a minimally invasive hiatal hernia repair. The researchers analyzed data from 12 patients who had this combined surgery between February 2020 and June 2021.

The symptoms that led these patients to have the surgery included heartburn, difficulty swallowing, and chronic anemia caused by Cameron’s ulcers. The average size of the hernia in these patients was 5.0 cm. The hernia repairs were performed either robotically or laparoscopically. The entire procedure took an average of 254 minutes.

One patient experienced difficulty swallowing after the surgery, which was resolved with further treatment. None of the patients reported symptoms of gas-bloat. At their follow-up appointments, all patients reported that their initial symptoms had completely disappeared. Four patients had further tests six months after the surgery, which showed no signs of acid reflux or inflammation of the esophagus.

The researchers concluded that this combined surgical approach is a safe and effective treatment for giant paraoesophageal hernia. It offers several advantages, such as a quicker repair process, lower rates of swallowing difficulties and gas-bloat after surgery, and a reduced risk of nerve injury and bleeding.

FAQs

  1. What is the combined surgical procedure for treating giant paraoesophageal hernia?
  2. What were the outcomes and benefits for patients who underwent this combined surgical procedure for giant paraoesophageal hernia?
  3. What are the potential complications or side effects of this combined surgery for hiatal hernia repair?

Doctor’s Tip

A helpful tip a doctor might give a patient about hiatal hernia repair is to follow post-operative instructions carefully, including dietary guidelines and restrictions on physical activity. It is important to attend all follow-up appointments to monitor recovery progress and address any concerns. Additionally, maintaining a healthy lifestyle, including regular exercise and a balanced diet, can help prevent recurrence of the hernia.

Suitable For

Patients with giant paraoesophageal hernias, especially those experiencing symptoms such as heartburn, difficulty swallowing, and chronic anemia caused by Cameron’s ulcers, are typically recommended for hiatal hernia repair. These patients may benefit from a combined surgical approach involving transoral incisionless fundoplication (TIF) and minimally invasive hiatal hernia repair, as shown in the study discussed above.

Timeline

Overall timeline for a patient before and after hiatal hernia repair:

  • Pre-surgery: Patient experiences symptoms such as heartburn, difficulty swallowing, and chronic anemia caused by Cameron’s ulcers. Diagnosis of a giant paraoesophageal hernia is made, with an average hernia size of 5.0 cm.
  • Surgery: Combined transoral incisionless fundoplication (TIF) and minimally invasive hiatal hernia repair is performed, either robotically or laparoscopically. The entire procedure takes an average of 254 minutes.
  • Post-surgery: One patient experiences temporary difficulty swallowing, which is resolved with further treatment. None of the patients report symptoms of gas-bloat. At follow-up appointments, all patients report complete resolution of initial symptoms. Further tests at six months show no signs of acid reflux or esophageal inflammation.
  • Conclusion: The combined surgical approach is deemed safe and effective for treating giant paraoesophageal hernia, with advantages such as quicker repair process, lower rates of post-surgery complications, and reduced risk of nerve injury and bleeding.

What to Ask Your Doctor

  1. What are the risks and potential complications associated with hiatal hernia repair surgery?
  2. How long is the recovery process after hiatal hernia repair surgery?
  3. Will I need to follow a specific diet or lifestyle changes after surgery to prevent the hernia from recurring?
  4. How long do the results of the surgery typically last?
  5. Are there any alternative treatment options for hiatal hernia that I should consider?
  6. What can I expect in terms of pain management after the surgery?
  7. Will I need to undergo any additional tests or follow-up appointments after the surgery?
  8. How experienced are you in performing hiatal hernia repair surgeries?
  9. What is the success rate of the combined procedure (TIF with hiatal hernia repair) for treating giant paraoesophageal hernia?
  10. How soon after the surgery can I resume normal activities and exercise?

Reference

Authors: Gergen AK, Wagh MS, Menard-Katcher P, Pratap A. Journal: Surg Laparosc Endosc Percutan Tech. 2022 Jun 1;32(3):404-408. doi: 10.1097/SLE.0000000000001044. PMID: 35648420