Our Summary

This research study aimed to show that adding a procedure known as fundic gastropexy (a type of stomach surgery) to a laparoscopic hiatal hernia repair (a minimally invasive surgery to fix a type of stomach hernia) and magnetic sphincter augmentation (a treatment for acid reflux disease that uses a magnetic device) can improve patient outcomes without changing the course of treatment. This was especially the case in patients who had a high risk of their hiatal hernia recurring.

The researchers looked at the medical records of 137 patients who had undergone this combination of treatments. They divided these patients into two groups: those with a high risk of hernia recurrence (86 patients) and those with a low risk (51 patients).

The results showed that the patients with a high risk of hernia recurrence who had the additional gastropexy surgery had better outcomes in terms of hernia recurrence, swallowing difficulties, and the number of post-operative procedures needed to examine the esophagus. However, there was no significant difference in the length of their hospital stays or the use of medications to reduce stomach acid between the two groups.

In conclusion, adding a gastropexy procedure to the treatment of high-risk patients does not seem to change the course of the treatment. However, it does seem to improve post-operative outcomes related to swallowing difficulties and the potential recurrence of the hernia.

FAQs

  1. What is the purpose of adding a fundic gastropexy procedure to a laparoscopic hiatal hernia repair and magnetic sphincter augmentation?
  2. Did the addition of a gastropexy procedure have any effect on the length of hospital stays or the use of medications to reduce stomach acid?
  3. How does the gastropexy procedure impact post-operative outcomes related to swallowing difficulties and hernia recurrence?

Doctor’s Tip

Therefore, a helpful tip a doctor might tell a patient about hiatal hernia repair is to consider discussing with your healthcare provider the option of adding a fundic gastropexy procedure to your laparoscopic hiatal hernia repair and magnetic sphincter augmentation if you are at a high risk of hernia recurrence. This additional procedure may help improve your outcomes and reduce the likelihood of complications post-surgery. It is important to have a thorough discussion with your doctor about the risks and benefits of this additional procedure to determine the best course of treatment for your specific situation.

Suitable For

Therefore, patients who are typically recommended for hiatal hernia repair with the addition of fundic gastropexy are those who have a high risk of hernia recurrence. These patients may have had previous unsuccessful treatments for their hiatal hernia or have other risk factors that make them more likely to experience a recurrence. Ultimately, the decision to include gastropexy in the treatment plan should be made on a case-by-case basis by the patient’s healthcare provider.

Timeline

Before the hiatal hernia repair:

  1. Patient experiences symptoms of acid reflux, such as heartburn, chest pain, and difficulty swallowing.
  2. Patient undergoes diagnostic tests, such as an endoscopy or barium swallow, to confirm the diagnosis of a hiatal hernia.
  3. Treatment options, including lifestyle changes, medications, or surgery, are discussed with the patient.
  4. Patient and surgeon decide on a laparoscopic hiatal hernia repair with fundic gastropexy and magnetic sphincter augmentation as the best course of action.

After the hiatal hernia repair:

  1. Patient undergoes the minimally invasive laparoscopic surgery to repair the hiatal hernia.
  2. Fundic gastropexy is performed to secure the stomach in place and prevent the hernia from recurring.
  3. Magnetic sphincter augmentation is used to treat acid reflux and improve symptoms.
  4. Patient is monitored post-operatively for any complications or difficulties with swallowing.
  5. Patient may need to take medications to reduce stomach acid and prevent acid reflux.
  6. Patient follows up with the surgeon for post-operative care and monitoring of the hernia repair.
  7. Patient experiences improved symptoms of acid reflux and swallowing difficulties following the surgery.
  8. Patient has a lower risk of hernia recurrence and may require fewer post-operative procedures to monitor the esophagus.

What to Ask Your Doctor

Some questions a patient should ask their doctor about hiatal hernia repair include:

  1. What is a hiatal hernia and why do I need surgery to repair it?
  2. What are the risks and benefits of undergoing laparoscopic hiatal hernia repair and fundic gastropexy?
  3. How will the addition of fundic gastropexy affect my recovery and long-term outcomes?
  4. What is the success rate of this combination treatment in preventing hernia recurrence?
  5. Will I still need to take medications for acid reflux after the surgery?
  6. What is the expected length of my hospital stay and recovery time?
  7. What are the potential complications or side effects of the surgery?
  8. How often will I need follow-up appointments after the surgery?
  9. Are there any dietary or lifestyle changes I should make to support my recovery?
  10. Are there alternative treatment options available for my hiatal hernia?

Reference

Authors: Allman R, Speicher J, Rogers A, Ledbetter E, Oliver A, Iannettoni M, Anciano C. Journal: Surg Endosc. 2021 Jul;35(7):3998-4002. doi: 10.1007/s00464-020-07789-w. Epub 2020 Jul 17. PMID: 32681373