Using surgery to treat a sliding hiatus hernia
When lifestyle changes and medical treatment fail to improve the symptoms of a sliding hiatus hernia, surgical options can be considered. Before surgery is undertaken, your health care professional will want to ensure that your symptoms are due to your hiatus hernia and that your symptoms are severe enough to warrant surgery. Some complications of acid reflux, such as bleeding, narrowing of the esophagus, or progressive changes of the cells that line the esophagus will also require that surgery be performed.
Nissen fundoplication
The most common surgical procedure is called a Nissen Fundoplication. In this procedure, your surgeon will return your stomach from your chest back into your abdomen. He or she will then wrap the top of your stomach around your esophagus, creating an envelope that acts as a valve. This increases the pressure in your lower esophagus, improving the natural barrier between your esophagus and stomach. This helps to prevent the reflux of acid into your esophagus.
This type of surgery results in relief of the symptoms of the sliding hiatus hernia in more than 90% of patients. In most cases, it is important to try other methods of treatment before considering surgery as an option. It is advisable to consult with a gastroenterologist (a physician specializing in diseases of the esophagus, stomach, liver and intestines) and a surgeon prior to considering surgery for your sliding hiatus hernia.
Using surgery to treat a paraesophageal hiatus hernia
Complications of a paraesophageal hiatus hernia
Although a paraesophageal hiatus hernia does not often cause symptoms, once it is discovered it should be operated on to prevent severe complications. Complications of a paraesophageal hiatus hernia can include incarceration, strangulation, and hemorrhage.
- Incarcerated paraesophageal hiatus hernia: This means that the portion of the stomach that is poking into the chest is stuck and cannot be moved. This increases the risk that the blood supply to that portion of the stomach will be cut off - a dangerous situation that could be life-threatening.
- Strangulated paraesophageal hiatus hernia: This occurs when the portion of the stomach that is in the chest twists on itself, cutting off its own blood supply.
- Hemorrhage:This can occur if for some reason the portion of the stomach in the chest starts to bleed. This is also a dangerous situation that could be life-threatening.
In the surgery to correct a paraesophageal hiatus hernia, your surgeon will return your stomach from your chest back into your abdomen. He or she will fix the hole in your diaphragm and will attach your stomach into your abdomen.
This surgery provides excellent results for most patients with paraesophageal hiatus hernias.