Our Summary

This research paper examines how a certain tool, called an Endoluminal functional lumen imaging probe (EndoFLIP), can predict the success of hiatal hernia repair surgery. Hiatal hernia is a condition where part of your stomach pushes up into your chest through an opening in your diaphragm. The EndoFLIP measures something called the distensibility index (DI), which is basically how much a certain part of your body can stretch.

The researchers wanted to see if the change in DI when the fluid volume in the balloon is increased from 30 to 40 mL, could predict dysphagia (difficulty in swallowing) after surgery.

The study included 103 patients who had undergone hiatal hernia repair and had their DIs measured using EndoFLIP. The researchers found a significant reduction in the DI after the creation of a barrier (a part of the surgical procedure). They also found that a minority of patients had a decrease or no change in DI when the balloon volume increased from 30 to 40 mL.

One month after surgery, patients reported significant improvements in their GERD-HRQL score (a measure of gastroesophageal reflux disease symptoms) and bloating. Interestingly, patients who showed a decrease or no change in DI with the balloon volume increase had a significant decrease in their dysphagia score.

So, what does all this mean? It means that the change in DI measured by the EndoFLIP might help predict how well patients will do after hiatal hernia repair surgery. Particularly, it may help predict who will have less trouble swallowing after the procedure. This could be a useful tool for surgeons and patients when planning and assessing the success of this type of surgery.

FAQs

  1. What is the Endoluminal functional lumen imaging probe (EndoFLIP) and how does it relate to hiatal hernia repair surgery?
  2. Can the EndoFLIP predict post-surgery dysphagia in patients undergoing hiatal hernia repair?
  3. How does the change in the distensibility index (DI) when the fluid volume in the balloon is increased relate to the success of hiatal hernia repair surgery?

Doctor’s Tip

One helpful tip a doctor might give a patient about hiatal hernia repair is to discuss the use of tools like EndoFLIP with their surgeon. This can help provide a more personalized approach to their surgery and potentially predict any potential side effects or complications, such as difficulty swallowing. By being informed and proactive, patients can work with their healthcare team to achieve the best possible outcome from their hiatal hernia repair surgery.

Suitable For

Typically, patients who are experiencing symptoms such as gastroesophageal reflux disease (GERD), difficulty swallowing, chest pain, or heartburn as a result of their hiatal hernia may be recommended for hiatal hernia repair surgery. Additionally, patients who have not responded well to medication or lifestyle modifications may be considered for surgery. The EndoFLIP tool discussed in this research paper could potentially help identify which patients may benefit the most from surgery and predict their outcomes post-surgery.

Timeline

  • Before surgery:
  1. Patient experiences symptoms of hiatal hernia such as heartburn, chest pain, difficulty swallowing, and acid reflux.
  2. Patient undergoes diagnostic tests such as endoscopy, pH monitoring, and possibly a barium swallow to confirm the diagnosis of hiatal hernia.
  3. Patient and surgeon discuss treatment options, including surgery, to repair the hiatal hernia.
  4. Patient undergoes preoperative evaluations and preparations for surgery.
  • After surgery:
  1. Patient undergoes hiatal hernia repair surgery, which may involve using EndoFLIP to measure the distensibility index (DI) during the procedure.
  2. Postoperative recovery period, during which the patient may experience pain, bloating, and difficulty swallowing.
  3. Follow-up appointments with the surgeon to monitor recovery and assess the success of the surgery.
  4. Patients report improvements in symptoms such as heartburn, acid reflux, and bloating.
  5. Patients who had their DI measured by EndoFLIP may have a better prediction of their postoperative outcomes, including dysphagia (difficulty swallowing) and gastroesophageal reflux disease symptoms.

Overall, the use of EndoFLIP in predicting the success of hiatal hernia repair surgery could potentially improve outcomes for patients and help surgeons tailor treatment plans more effectively.

What to Ask Your Doctor

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

  1. How will the EndoFLIP procedure be performed during my hiatal hernia repair surgery?
  2. What is the significance of the distensibility index (DI) measured by the EndoFLIP in predicting the success of the surgery?
  3. How will the change in DI when the balloon volume increases from 30 to 40 mL affect my post-surgery symptoms, such as dysphagia?
  4. Can the EndoFLIP results help determine if I am at a higher risk for complications or need additional follow-up care after the surgery?
  5. What are the potential benefits of using EndoFLIP in assessing my hiatal hernia repair compared to other diagnostic tools or methods?
  6. Are there any limitations or risks associated with using EndoFLIP in predicting the outcomes of my surgery?
  7. How will the EndoFLIP results be used in planning and monitoring my recovery process after the hiatal hernia repair surgery?
  8. Are there any specific lifestyle changes or precautions I should take based on the EndoFLIP results to improve my post-surgery outcomes?
  9. What are the chances of experiencing dysphagia or other complications after the surgery based on the EndoFLIP findings?
  10. How often will my DI be monitored using EndoFLIP during the post-operative follow-up visits, and how will this information guide my long-term care plan for hiatal hernia repair?

Reference

Authors: Shah A, Nguyen DT, Meisenbach LM, Chihara R, Chan EY, Graviss EA, Kim MP. Journal: Surg Endosc. 2022 Jul;36(7):4764-4770. doi: 10.1007/s00464-021-08817-z. Epub 2021 Oct 28. PMID: 34713341