Hiatal hernia is an anatomical abnormality, in which a portion of the stomach protrudes upward into the chest through the diaphragm, which is a thin muscle that separates the abdominal cavity from the chest. It is situated just beneath the lungs and normally has a small opening known as hiatus. This opening allows the esophagus to pass down through the chest and enter the abdomen. In case of the affected people, the hiatal opening is larger than normal and allows a portion of the stomach to slip up into the chest. This causes gastric acid back flow from the stomach into the esophagus and can result in gastroesophageal reflux (GER). If this condition persists for several years, it could damage the lining of the esophagus and may cause esophageal cancer. It may also cause volvulus, which involves twisting of the intestines, and that would require an immediate treatment. Hiatal hernia is a common condition, especially in people over the age of 50. However, this condition may be congenital and some children are usually born with it.
The repair of this medical condition is necessary to prevent the back flow of contents from the abdomen into the chest. This type of hernia can be rectified by two types of surgical procedures - open hiatal hernia repair and laparoscopy. Open hiatal hernia surgical repair is also known as anti-reflux surgery as it would prevent the reflux symptoms associated with this medical condition.
Open Hiatal Hernia Repair
This surgery is performed under general anesthesia. A small incision is made in the abdomen and the stomach and esophagus are put back in place and then the hiatus is tightened. The upper part of the stomach also known as fundus, may be wrapped around the esophagus so that it does not move from its place. Sometimes, a temporary tube is placed from the stomach through the abdominal wall that helps in keeping the stomach and esophagus in place and also reduces heartburns associated with acid reflux.
Laparoscopy is also called 'keyhole' surgery. It involves the use of a laparoscope, which is a thin, hollow tube with a mini camera at one end. An incision, smaller than that in the open surgery, is made in the abdomen and the laparoscope is inserted through it. Surgical tools are sent through the laparoscope and the procedure is done using the mini camera. Laparoscopic procedures are less painful and have less scarring with shorter hospital stays.
This repair involves risks of anesthesia as in any other surgery, like breathing problems, reaction to medications, or problems related to the heart. The complications associated particularly with the surgical procedure includes discomfort while swallowing, difficulty in burping or vomiting, damage to the esophagus, and recurrence of the medical condition. One would have to follow a specific diet which omits all the gassy foods, for a quick recovery from the surgery.
It is always necessary to consult the concerned doctor, before opting for any repair methods or surgical procedures so as to rule out the possibility of any further complications.
Disclaimer: This HealthHearty article is for informative purposes only, and should not be used as a replacement for expert medical advice.