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A hiatal hernia occurs when part of the stomach moves upward into the chest. If the hernia causes severe symptoms or is probable to cause complications, then hiatal hernia surgery may exist required.

Non anybody who has a hiatal hernia will require surgery. Many people volition exist able to treat the condition with medication or lifestyle changes. However, for those who exercise need surgery, there is a range of procedures bachelor, the virtually common beingness Nissen fundoplication.

This article discusses hiatal hernia surgery procedures, expected recovery times. complications, and risks.

Image showing a normal stomach and hiatal hernia that may require surgery Share on Pinterest
Hiatal hernias can ofttimes exist treated with medication or lifestyle changes, only some may require surgery.

Nearly hiatal hernias practice not cause symptoms, and therefore treatment is non usually necessary. Those who have mild symptoms, such every bit heartburn, acid reflux, or gastroesophageal reflux disorder (GERD) may be able to treat their condition with medications or lifestyle changes.

However, surgery may be recommended if:

  • symptoms are severe and interfere with quality of life
  • symptoms practice not respond to other treatments
  • the hernia is at take a chance of condign strangulated, which is where the blood supply to the herniated tissue is cut off — a situation that tin can be fatal
  • symptoms include bleeding, ulcers, or narrowing of the nutrient pipe (esophagus), which is known as an esophageal stricture

In that location are three types of surgery for a hiatal hernia: Nissen fundoplication (keyhole surgery), open repairs, and endoluminal fundoplication. All three procedures crave a general anesthetic.

Nissen fundoplication

A Nissen fundoplication is the well-nigh unremarkably performed surgery for a hiatal hernia. This procedure uses laparoscopic repair or keyhole surgery. This surgery is minimally invasive and but requires the surgeon to make a few tiny incisions in the abdomen.

The surgeon inserts a laparoscope, which is a thin tube with a light and a camera, into the abdomen to repair the hernia. The surgeon may besides tighten the stomach opening to preclude the hernia from coming dorsum.

Laparoscopic repair has some advantages over other types of hiatal hernia surgery. These include:

  • less risk of infection
  • less painful
  • reduced scarring
  • less time in the hospital
  • recovery is normally quicker

Open up surgery

Open surgery involves making a larger incision in the abdomen then that the surgeon can fix the hernia. This procedure carries more risks than laparoscopic repair.

A surgeon volition pull the stomach dorsum upwards into the abdominal cavity and wrap the upper portion, chosen the fundus, effectually the lower function of the food pipe. This creates a tight sphincter which stops the stomach acid from leaking upward into the food pipe (reflux).

Sometimes, the surgeon may need to insert a tube to keep the stomach in identify. The doctor will remove the tube after several weeks.

Endoluminal fundoplication

This procedure is relatively new and is even less invasive than laparoscopic repair, though it is not commonly used. The surgeon does not need to make any incisions. Instead, they place an endoscope (a tube with a calorie-free and camera) down the throat and into the nutrient pipage.

The surgeon tightens the area where the breadbasket and esophagus bring together to preclude reflux.

Still, this treatment may have its limitations. According to an interview published in the journal Gastroenterology and Hepatology in 2022, the endoluminal devices adult to date are not entirely reliable, and many people experience their symptoms coming dorsum.

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After surgery, a person should drink clear liquids and so move onto soft foods, such as mashed potatoes.

After laparoscopic surgery, most people will not experience much pain, but they may feel discomfort in their abdomen and chest and have difficulty swallowing. This ordinarily passes within 48 hours.

Later a laparoscopy, a person may be able to get home the same day if they take recovered from the coldhearted. Otherwise, they may spend a dark in the infirmary and should be able to walk around the twenty-four hour period afterward the surgery.

A person may soon experience well over again just may find that they tire easily.

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

  • wash the incision area daily with plain lather and water
  • shower instead of bathing, and avoid the use of pools and hot tubs
  • walk near when possible to stop blood clots from forming in the leg
  • avoid drinking through a straw
  • practice specific breathing and coughing exercises to strengthen the diaphragm

In the weeks after surgery, the UK National Health Service (NHS) recommend the post-obit:

  • fugitive any heavy lifting for 2 to 3 weeks
  • fugitive driving for vii to ten days
  • returning to piece of work inside two to 3 weeks, or whenever a person is feeling well enough
  • taking painkillers for several days afterward surgery to minimize discomfort

A person will need to follow a specific diet afterward surgery. It is advisable to beverage clear liquids immediately after surgery and move onto soft or liquefied foods, including mashed potatoes, smoothies, and soups, the following day. A person should too avoid foods that cause gas and bloating.

During recovery, information technology might be a good idea for people to consume several smaller meals throughout the twenty-four hours instead of iii large ones.

Most people can return to their regular diet between 3 to half dozen weeks later surgery.

However, even after a person makes a full recovery, their doctor may recommend they continue to limit or avert foods that contribute to gas, bloating, and acrid reflux symptoms, such equally:

  • acidic foods, including citrus fruits and tomato products
  • alcohol
  • beans and lentils
  • carbonated beverages
  • corn
  • cruciferous vegetables, including broccoli, cabbage, and cauliflower

Open surgery will usually require a lengthier stay in the hospital and an extended recovery time.

Nissen fundoplication is very effective for relieving symptoms of GERD. A 2009 study estimates that this surgery achieves a success rate of ninety to 95 percentage.

The same study also suggests that fifty-fifty when the laparoscopic surgery has to be carried out once more to command reflux symptoms further, the success rate is 86 percent.

The NHS in the Uk judge that 80 to 85 per centum of people volition continue to accept relief from symptoms ten years after surgery.

All surgeries comport risks, including the risk of:

  • bleeding
  • infection
  • injury to internal organs

However, the adventure with laparoscopic procedures is lower than with open up surgery. It is estimated that laparoscopic repair carries a bloodshed rate of only 0.57 percent, and open surgery carries a mortality rate of i.0 to 2.7 per centum.

Complications associated with hiatal hernia surgery include:

  • abdominal bloating
  • diarrhea
  • difficulty belching or airsickness
  • difficulty swallowing
  • nausea
  • recurrence of the hernia or reflux

While surgery is an constructive treatment for a hiatal hernia that causes severe symptoms, people with mild symptoms may find relief using medications or home treatments.

Medication

Heartburn and acrid reflux may be treated with:

  • Antacids. Antacid medication works by neutralizing stomach acid. Avoid overusing these every bit they can cause diarrhea or kidney problems. These medications are bachelor over the counter, by prescription, or to buy online.
  • H2 receptor blockers. This medication is designed to limit the production of tummy acid. Medications may contain cimetidine and famotidine. Stronger H2 receptor blockers are available past prescription.
  • Proton pump inhibitors (PPIs). These drugs block acid production for longer than H2 receptor blockers, giving the tissue of the esophagus more time to heal. PPIs may be bought at a pharmacy or may be prescribed by a md.

Home treatments

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People may feel a reduction in their acid reflux when they quit smoking.

Some people tin can experience relief from reflux by making the post-obit lifestyle changes:

  • losing weight if overweight
  • eating five to six pocket-sized meals daily rather than three big ones
  • avoiding foods that cause acrid reflux, including fried foods, acidic foods, booze, and caffeine
  • eating the last meal of the day at to the lowest degree 3 hours before bedtime
  • quitting smoking
  • raising the caput of the bed by 6 inches to prevent acid rising during sleep
  • wearing loose-fitting clothing to prevent pressure on the abdomen

Hiatal hernias usually practise not cause symptoms. If they practise, symptoms may be treated with medications or lifestyle changes, though if these practice non work, surgery may requite long-term relief from acid reflux and GERD.

Even when hiatal hernia surgery is necessary, the procedure is usually minimally invasive and has a high success rate. Virtually people make a full recovery in just a few weeks.