Our Summary

The study investigated whether preoperative motility studies are necessary when planning a specific surgical repair for hiatal hernia, a common condition in adults which can cause acid reflux or difficulty swallowing. The team looked at 185 patients who underwent a minimally invasive hiatal hernia repair between 2014 and 2018. They compared those who had a preoperative motility study with those who did not. They found that not having a preoperative motility study did not lead to increased postoperative complications, including leaks, readmissions, and deaths within 30 days. Dysphagia (difficulty swallowing) rates and interventions due to recurring symptoms after surgery were also similar in both groups. Therefore, they suggest that while a preoperative motility study is reasonable, it may not be absolutely necessary when planning this specific type of hiatal hernia repair.

FAQs

  1. What is the purpose of a preoperative motility study in hiatal hernia repair?
  2. Does not having a preoperative motility study lead to more complications after hiatal hernia repair?
  3. Are the rates of difficulty swallowing and interventions due to recurring symptoms after surgery different between those who had a preoperative motility study and those who did not?

Doctor’s Tip

A helpful tip a doctor might tell a patient about hiatal hernia repair is to discuss with them the option of having a preoperative motility study. While it may not be absolutely necessary for successful surgery, it can provide valuable information about the function of the esophagus and help guide the surgical approach. Additionally, patients should be aware that not having a preoperative motility study does not necessarily increase the risk of postoperative complications.

Suitable For

Patients who are typically recommended for hiatal hernia repair include those who have severe symptoms such as frequent heartburn, regurgitation, chest pain, difficulty swallowing, or vomiting, despite trying conservative treatments such as medications or lifestyle changes. Additionally, patients who have complications related to their hiatal hernia, such as Barrett’s esophagus, esophagitis, or strictures, may also be recommended for surgery. Patients who have a large hiatal hernia that is causing significant displacement of the stomach into the chest cavity may also benefit from surgical repair. Ultimately, the decision to undergo hiatal hernia repair should be made in consultation with a healthcare provider after a thorough evaluation of the individual’s symptoms and medical history.

Timeline

  • Patient experiences symptoms of hiatal hernia such as acid reflux, heartburn, chest pain, difficulty swallowing, and regurgitation
  • Patient undergoes diagnostic tests such as endoscopy, barium swallow, and pH monitoring to confirm the diagnosis of hiatal hernia
  • Patient consults with a surgeon to discuss options for hiatal hernia repair
  • Patient may undergo preoperative motility studies to assess esophageal function before surgery
  • Patient undergoes minimally invasive hiatal hernia repair surgery
  • Postoperatively, patient may experience some discomfort and require pain medication
  • Patient is discharged from the hospital within a few days after surgery
  • Patient follows a diet and activity restrictions as advised by the surgeon
  • Patient attends follow-up appointments to monitor recovery and address any concerns
  • Patient gradually resumes normal activities and diet as instructed by the surgeon
  • Patient experiences improvement in symptoms such as acid reflux and difficulty swallowing after surgery

What to Ask Your Doctor

  1. What type of hiatal hernia repair procedure do you recommend for me?
  2. What are the potential risks and complications associated with the surgery?
  3. How long is the recovery period after hiatal hernia repair surgery?
  4. Will I need to make any lifestyle changes or follow a specific diet after the surgery?
  5. How successful is this type of surgery in treating symptoms such as acid reflux and difficulty swallowing?
  6. Are there any alternative treatments or non-surgical options for managing hiatal hernia?
  7. What can I expect in terms of long-term outcomes and prognosis after the surgery?
  8. How often will I need to follow up with you after the surgery?
  9. Are there any specific precautions I should take before and after the surgery to ensure optimal recovery?
  10. Do I need to undergo any additional tests or evaluations before the surgery, such as a preoperative motility study?

Reference

Authors: Marthy AG, Nguyen P, Su E, Mounsey M, Sahm E, Olutola O, Singh TP, Fabian T. Journal: J Surg Res. 2024 Oct;302:18-23. doi: 10.1016/j.jss.2024.06.043. Epub 2024 Jul 26. PMID: 39067159