Our Summary

This study looked at how often symptoms returned in patients who had a specific type of surgery for large hiatal hernias. Hiatal hernias occur when part of the stomach pushes up through an opening in the diaphragm, and they can cause symptoms like heartburn and difficulty swallowing. Surgeons can repair them using a minimally invasive (laparoscopic) procedure, and in this study, the procedure did not involve lengthening the esophagus.

The researchers looked at records from one surgeon who performed this type of surgery on 215 patients between 2009 and 2015. They excluded patients who had smaller hernias or who needed a second surgery, leaving 131 patients in the study. The patients filled out a questionnaire about their symptoms a couple of years after their surgery; 76% of them responded.

The results were very positive: 86% of the patients who responded were free of their pre-surgery symptoms, 92% were happy with the results of the surgery, and 74% no longer had to take medication to reduce stomach acid. Only 8% needed a second surgery because their symptoms returned.

The study concluded that this type of surgery for large hiatal hernias has low risks and leads to high patient satisfaction. The surgery can be done without lengthening the esophagus, and it’s rare for patients to need a second surgery because their symptoms come back.

FAQs

  1. What is a hiatal hernia and what symptoms does it cause?
  2. How effective is the laparoscopic procedure for large hiatal hernia repair?
  3. Is it common for patients to need a second surgery after the initial hiatal hernia repair?

Doctor’s Tip

One helpful tip a doctor might tell a patient about hiatal hernia repair is to follow post-operative care instructions carefully. This may include avoiding heavy lifting, sticking to a soft diet for a period of time, and taking prescribed medications as directed. By following these instructions, patients can help ensure a successful recovery and reduce the risk of complications.

Suitable For

Patients who are typically recommended hiatal hernia repair are those with large hiatal hernias that are causing symptoms such as heartburn and difficulty swallowing. These patients may have tried other treatments such as medication to reduce stomach acid but have not found relief. Patients who are generally healthy and able to tolerate surgery are good candidates for the procedure. It’s important for patients to discuss their specific symptoms and medical history with their healthcare provider to determine if hiatal hernia repair is the right treatment option for them.

Timeline

Before hiatal hernia repair:

  • Patient may experience symptoms such as heartburn, difficulty swallowing, chest pain, and regurgitation of food.
  • Patient may undergo diagnostic tests such as endoscopy, barium swallow, and pH monitoring to confirm the presence of a hiatal hernia.
  • Patient may be prescribed medications to manage symptoms, such as proton pump inhibitors or H2 blockers.

After hiatal hernia repair:

  • Patient undergoes minimally invasive (laparoscopic) surgery to repair the hiatal hernia.
  • Recovery period typically involves a short hospital stay and a few weeks of limited activity.
  • Patient may experience some discomfort and bloating in the days following surgery.
  • Patient gradually resumes normal activities and diet under the guidance of their healthcare provider.
  • Follow-up appointments are scheduled to monitor progress and ensure the hernia is properly repaired.
  • In the long term, the majority of patients experience relief from their pre-surgery symptoms and are able to discontinue medication for stomach acid.

What to Ask Your Doctor

  1. What type of surgery will be performed for my hiatal hernia repair?
  2. What are the potential risks and complications associated with the surgery?
  3. How long is the recovery period after the surgery?
  4. Will I need to make any lifestyle changes or follow a specific diet after the surgery?
  5. How likely is it that my symptoms will return after the surgery?
  6. Will I need to take medication for stomach acid after the surgery?
  7. How experienced is the surgeon in performing this type of surgery?
  8. Are there any alternative treatment options for my hiatal hernia?
  9. How soon after the surgery can I return to normal activities?
  10. What follow-up care will be needed after the surgery?

Reference

Authors: Banki F, Kaushik C, Roife D, Mitchell KG, Miller CC 3rd. Journal: Semin Thorac Cardiovasc Surg. 2017 Autumn;29(3):418-425. doi: 10.1053/j.semtcvs.2017.05.011. Epub 2017 May 29. PMID: 29031705