Our Summary

This research paper looked at the possibility and results of doing laparoscopic hiatal hernia repairs (a type of minimally invasive surgery to fix hiatal hernias) on the same day as the patient’s admission. The researchers also changed the normal anesthesia from opioids to non-opioid options for better recovery. They checked the results by looking at how long patients stayed in the hospital, how many needed more care after surgery, and how many had to come back to the emergency department.

Between April 2017 and September 2022, they performed 518 of these surgeries on 491 patients. The majority of surgeries were successful in being performed and completed on the same day as planned, with a low number of patients needing to visit the emergency department or being readmitted to the hospital after being discharged.

The research found that not using opioids for anesthesia, having a lower ASA (a score that assesses a patient’s physical health), and shorter surgery time increased the chances of having the surgery done on the same day. On the other hand, having a higher ASA score and longer operation time made it less likely to have the surgery done on the same day.

The study concluded that this type of hernia repair surgery can be done on the same day in most cases, with good results and a low number of post-surgery hospital visits. This was especially true when non-opioid anesthesia was used, the patient was in good health, and the surgery time was short.

FAQs

  1. What is the benefit of performing laparoscopic hiatal hernia repairs on the same day as the patient’s admission?
  2. How does the use of non-opioid anesthesia affect the recovery process after hiatal hernia repair surgery?
  3. What factors were found to increase the chances of performing the surgery on the same day?

Doctor’s Tip

A helpful tip a doctor might tell a patient about hiatal hernia repair is to follow the pre-operative instructions provided by the healthcare team, such as fasting before surgery and avoiding certain medications. Additionally, it may be beneficial to discuss pain management options with your healthcare provider to minimize the need for opioids post-surgery and potentially speed up recovery. Lastly, maintaining a healthy lifestyle and following any post-operative care instructions can help promote successful healing after hiatal hernia repair surgery.

Suitable For

Patients who are typically recommended for hiatal hernia repair surgery include those who are experiencing severe symptoms such as heartburn, regurgitation, difficulty swallowing, chest pain, or respiratory issues. In addition, patients who have a hiatal hernia that is causing complications such as Barrett’s esophagus or esophageal strictures may also be recommended for surgery. Patients who have a hiatal hernia that is not responding to medication or lifestyle changes may also be candidates for surgery. Ultimately, the decision to undergo hiatal hernia repair surgery is made on a case-by-case basis by the patient and their healthcare provider.

Timeline

In summary, a patient who undergoes a laparoscopic hiatal hernia repair may experience the following timeline:

Before surgery:

  • Consultation with a healthcare provider to discuss symptoms and treatment options
  • Preoperative testing and preparation, including imaging studies and blood work
  • Education on the surgery, potential risks, and postoperative care

Day of surgery:

  • Check-in at the hospital or surgical center
  • Administration of anesthesia and preparation for surgery
  • Laparoscopic hiatal hernia repair procedure, which typically takes 1-2 hours
  • Recovery in the post-anesthesia care unit (PACU) before being transferred to a hospital room or discharged home

After surgery:

  • Postoperative pain management and monitoring for complications
  • Gradual resumption of normal activities and diet under the guidance of healthcare providers
  • Follow-up appointments to assess healing and address any concerns
  • Long-term management of hiatal hernia symptoms, which may include lifestyle modifications and medication

Overall, the goal of hiatal hernia repair is to alleviate symptoms and improve quality of life for the patient. With advances in surgical techniques and anesthesia, many patients can undergo this procedure on the same day as their admission, leading to faster recovery and fewer complications.

What to Ask Your Doctor

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

  1. What are the different treatment options available for hiatal hernia repair, and why do you recommend a laparoscopic approach?
  2. What are the potential risks and complications associated with hiatal hernia repair surgery?
  3. How long will the surgery take, and what is the expected recovery time?
  4. Will I need to stay in the hospital after the surgery, and if so, for how long?
  5. What type of anesthesia will be used during the surgery, and are there any alternatives to opioids that can be used?
  6. What can I expect in terms of pain management after the surgery?
  7. How soon after the surgery can I resume normal activities, such as eating and exercising?
  8. What follow-up care will be needed after the surgery, and how will my progress be monitored?
  9. What are the long-term outcomes and success rates of hiatal hernia repair surgery?
  10. Are there any lifestyle changes or dietary modifications that I should consider to prevent the recurrence of a hiatal hernia?

Reference

Authors: Hoffman C, Shah S, Mai M, Miller A, Banki F. Journal: J Gastrointest Surg. 2023 Nov;27(11):2287-2296. doi: 10.1007/s11605-023-05807-5. Epub 2023 Sep 5. PMID: 37670107