Laparoscopic Hiatal
Hernia Repair

There are four types of hiatal hernias they are as follows:

1. First type is the sliding hernia where there is a displacement of gastroesophageal junction into the thoracic cavity. This is one of the most common types of hiatal hernias and this account to 95% of the cases of hiatal hernias.
2. The second type is called the paraesophageal hernia where gastroesophageal junction maintains its position but the gastric fundus herniates through the diaphragmatic hiatus.
3. In the third type both gastroesophageal junction and the stomach herniate above the diaphragm.
4. The fourth type of hernia occurs when other organs, such as the colon, in addition to the stomach herniate above the diaphragm.

The symptoms of hiatal hernia are as follows:

• Heartburn
• Difficulty in swallowing food
• Shortness of breath
• Chest and abdominal pain
• Backflow of stomach acid into the esophagus or acid reflux
• Vomiting of blood or passing of black stools, which may indicate gastrointestinal bleeding
• Feeling full as soon as you finish eating
• Regurgitation of food or liquids into the mouth
• Belching

A Laparoscopic hiatal hernia repair is similar to other laparoscopic procedures. Where the surgeon makes incisions through which a laparoscope (a laparoscope is a small instrument with a narrow tube which has light source and camera at the end of the tube) is inserted and using the Laparoscope’s video camera the surgeon is able to locate the hernia and through the other incisions that are made surgical instruments are inserted and the hernia is corrected.

In addition to this a process called Nissen fundoplication is carried out which reduces the acid reflux. The Nissen fundoplication procedure consists of a 360 degree Trans abdominal fundoplication.

A fundoplication is the suturing of the fundus located in the stomach and around the esophagus. Depending upon the condition of the hernia the doctor might also choose switch to an open procedure if needed.

If you have a prior medical condition and you are taking medicines prescribed by a doctor please make sure you inform the surgeon beforehand.

If you have a habit of smoking you will be advised to stop smoking a few weeks prior to the date of the operation as smoking may result in reoccurrence of hernia or may cause infections resulting in failure of the procedure. Quitting smoking enhances the chances of success.

In the days after surgery, a person will usually be advised to:

• Wash the incision area daily with plain soap and water and keep the region clean
• Take a shower instead of bathing, and avoid the use of pools and hot tubs
• Walk about when possible to stop blood clots from forming in the leg
• Avoid drinking through a straw
• Practice breathing and coughing exercises to strengthen the diaphragm as directed by the doctor
• Avoid heavy lifting for the next few weeks
• Not to drive any vehicle
• The patient will prescribed pain killers to minimize pain caused due to incisions
• The patient will also be asked to follow specific diet which will require him/her to consume soft or liquefied foods, including mashed potatoes, smoothies, and soups

The Patient will be under the supervision of Dr. Kiran KJ, so each and every aspect from surgery to recovery will be well taken care of by his team and hence there is no need to worry about anything.

If you have a prior medical condition and you are taking medicines prescribed by a doctor please make sure you inform the surgeon beforehand.

If you have a habit of smoking you will be advised to stop smoking a few weeks prior to the date of the operation as smoking may result in reoccurrence of hernia or may cause infections resulting in failure of the procedure. Quitting smoking enhances the chances of success.