Our Summary

This research paper looks at a new method for treating a type of hernia known as a paraesophageal hernia. This type of hernia occurs when part of the stomach pushes through an opening in the diaphragm (the muscle that separates the chest from the abdomen), and moves up into the chest.

Traditionally, hernias like this have been treated with a surgical procedure that uses synthetic mesh to support and strengthen the area. However, this method can sometimes cause difficulties in swallowing and damage to the esophagus. Another treatment option involves using a biological mesh, but this is quite expensive and doesn’t necessarily reduce the chance of the hernia coming back in the long term.

The new method tested in this study involves using a part of the body called the falciform ligament (a thin, crescent-shaped band of tissue that connects the front of the liver to the front of the abdominal wall) to reinforce the area during surgery. The study followed 104 patients who underwent this procedure. The results showed a significant decrease in the severity and frequency of symptoms, and only five patients developed a recurrence of their hernia. Of these, only three required further surgery.

In conclusion, the study suggests that using the falciform ligament to reinforce the area during surgery is a promising option for treating paraesophageal hernias. It appears to be effective in reducing symptoms and the rate of recurrence, and further follow-up will continue to assess its value.

FAQs

  1. What is a paraesophageal hernia and how is it traditionally treated?
  2. What is the new method for treating a paraesophageal hernia that is discussed in this study?
  3. What are the potential benefits of using the falciform ligament in hernia repair surgery, as suggested by this research?

Doctor’s Tip

A helpful tip a doctor might tell a patient about hiatal hernia repair is to follow post-operative instructions carefully, including avoiding lifting heavy objects, eating smaller meals, and taking prescribed medications as directed. It is also important to attend follow-up appointments with your doctor to monitor your recovery and ensure the hernia has been successfully repaired. If you experience any new or worsening symptoms, such as difficulty swallowing or chest pain, be sure to contact your doctor right away.

Suitable For

Patients who are typically recommended for hiatal hernia repair include those who experience symptoms such as heartburn, chest pain, difficulty swallowing, regurgitation, and vomiting. Additionally, patients who have complications such as bleeding, anemia, or a hernia that is causing respiratory issues may also be candidates for surgery. Patients who have a paraesophageal hernia, in particular, may benefit from surgery to prevent complications such as strangulation of the stomach or esophagus.

Timeline

Before the hiatal hernia repair, a patient may experience symptoms such as heartburn, chest pain, difficulty swallowing, regurgitation of food, and feeling full quickly after eating. These symptoms may worsen when lying down or bending over. The patient may also undergo diagnostic tests such as an upper endoscopy or barium swallow to confirm the presence of a hiatal hernia.

After the hiatal hernia repair surgery, the patient will typically stay in the hospital for a few days for monitoring and recovery. They may experience some discomfort and pain at the incision site, as well as bloating and difficulty swallowing. The patient will be advised to follow a specific diet and avoid certain foods to prevent complications. Over time, the patient should experience a decrease in their symptoms and an improvement in their quality of life. Follow-up appointments will be scheduled to monitor the healing process and assess the success of the surgery.

What to Ask Your Doctor

Some questions a patient should ask their doctor about hiatal hernia repair using the falciform ligament method include:

  1. What is a paraesophageal hernia and how is it different from other types of hiatal hernias?
  2. How does using the falciform ligament in surgery differ from traditional methods using synthetic mesh or biological mesh?
  3. What are the potential risks and complications associated with using the falciform ligament in hernia repair surgery?
  4. What is the success rate of this new method in terms of reducing symptoms and preventing hernia recurrence?
  5. How long is the recovery process after undergoing hernia repair surgery using the falciform ligament?
  6. Are there any specific lifestyle changes or dietary modifications I should make after the surgery?
  7. How frequently will I need follow-up appointments to monitor my recovery and check for any complications?
  8. Are there any alternative treatment options available for my paraesophageal hernia?
  9. What qualifications and experience do you have in performing hernia repair surgeries using the falciform ligament method?
  10. Can you provide me with any additional information or resources to help me better understand my condition and treatment options?

Reference

Authors: Grossman RA, Brody FJ, Schoolfield CS, Biteman B, Zeddun S. Journal: J Gastrointest Surg. 2018 Jul;22(7):1144-1151. doi: 10.1007/s11605-018-3798-6. Epub 2018 May 7. PMID: 29736666