Our Summary

This research paper looks at the best surgical methods for treating paraesophageal hernias, which are hernias that occur in the area where the esophagus joins the stomach. There are different surgical techniques available, including laparoscopic and robotic approaches, and sometimes a mesh is used to strengthen the closure of the hernia. However, it’s still not clear whether using mesh materials is beneficial. The authors of this paper looked at various studies that have been done on this topic, particularly focusing on the use of biologic (natural materials) and bioabsorbable (materials that the body can absorb) meshes. They found a wide range of studies with different results, but most suggested that using a mesh could be beneficial. However, the authors conclude that there isn’t enough strong evidence to firmly support the use of these types of meshes in hernia surgery, and they suggest that more research is needed.

FAQs

  1. What are the different surgical techniques available for treating paraesophageal hernias?
  2. What are biologic and bioabsorbable meshes, and how are they used in hernia surgery?
  3. What is the current research suggesting about the use of mesh materials in hernia surgery?

Doctor’s Tip

One helpful tip a doctor might tell a patient about hiatal hernia repair is to follow post-operative instructions carefully, including avoiding heavy lifting, eating small meals, and taking prescribed medications as directed. It’s important to follow up with your surgeon for regular check-ups to monitor your recovery and ensure the hernia repair is successful. If you experience any new or worsening symptoms, such as chest pain, difficulty swallowing, or reflux, it’s important to contact your healthcare provider promptly for further evaluation.

Suitable For

Typically, patients who are recommended hiatal hernia repair are those who experience symptoms such as heartburn, acid reflux, chest pain, difficulty swallowing, regurgitation, and vomiting. Hiatal hernias can also lead to complications such as gastroesophageal reflux disease (GERD), Barrett’s esophagus, and esophageal ulcers. Patients who have large hiatal hernias, paraesophageal hernias, or hernias that are causing significant symptoms or complications are often recommended for surgical repair. Additionally, patients who do not respond well to conservative treatments such as medications or lifestyle changes may also be candidates for hiatal hernia repair.

Timeline

Before hiatal hernia repair:

  1. Patient experiences symptoms such as heartburn, chest pain, difficulty swallowing, regurgitation, and feeling full quickly after eating.
  2. Patient undergoes diagnostic tests such as endoscopy, barium swallow, and pH monitoring to confirm the diagnosis of hiatal hernia.
  3. Patient may be prescribed medications to manage symptoms, such as proton pump inhibitors or H2-receptor antagonists.

After hiatal hernia repair:

  1. Patient undergoes surgery to repair the hiatal hernia, which may involve laparoscopic or robotic techniques.
  2. During surgery, the hernia is reduced back into the abdomen and the opening in the diaphragm is closed to prevent the hernia from recurring.
  3. Patient may experience post-operative pain and discomfort, which can be managed with pain medications.
  4. Patient is advised to follow a special diet to prevent straining the surgical repair, such as avoiding heavy lifting and certain foods that can trigger symptoms.
  5. Patient may undergo follow-up appointments with their surgeon to monitor their recovery and ensure that the hernia has been successfully repaired.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with hiatal hernia repair surgery?
  2. How long is the recovery period after surgery and what can I expect during the recovery process?
  3. Are there any dietary or lifestyle changes I should make before or after the surgery?
  4. What type of surgical approach do you recommend for my specific hernia, and why?
  5. Will a mesh be used during the surgery, and if so, what type of mesh material will be used?
  6. What are the potential benefits of using a mesh in hernia repair surgery?
  7. What are the success rates of hiatal hernia repair surgery with and without the use of a mesh?
  8. How will the use of a mesh affect the long-term outcomes of the surgery?
  9. Are there any alternative treatment options for hiatal hernia that do not involve surgery?
  10. How many hiatal hernia repair surgeries have you performed and what is your success rate?

Reference

Authors: Panait L, Novitsky YW. Journal: Surg Technol Int. 2017 Jul 25;30:182-187. PMID: 28693045