Hiatal hernia Repair

When the opening (hiatus) in the muscle between the abdomen and chest (diaphragm) is too large, some of the stomach can slip up into the chest cavity. This can cause heartburn (gastro-esophageal reflux: GER) as gastric acid backflows from the stomach into the esophagus.

Patients experiencing persistent reflux symptoms may also benefit from evaluation through our related hernia surgery services.

Hiatal hernia repair may be recommended when you has:

• Severe heartburn
• Severe inflammation of the esophagus from the backflow of gastric fluid (reflux)
• Narrowing of the opening (hiatus) through the diaphragm (esophageal stricture)
• Chronic inflammation of the lungs (pneumonia) from frequent breathing in (aspiration) of gastric fluids
• When the stomach gets blocked and swallowing food becomes difficult or painful.

While you is deep asleep and pain-free (general anesthesia), an incision is made in the abdomen. The stomach and lower esophagus are placed back into the abdominal cavity. The opening in the diaphragm (hiatus) is tightened and the stomach is stitched in position to prevent reflux. The upper part of the stomach (fundus) may be wrapped around the esophagus (fundoplication) to reduce reflux.

For questions about surgical options, patients are encouraged to contact our office to schedule a consultation.

Patients may need to spend 3 to 10 days in the hospital after surgery. A tube will be placed into the stomach through the nose and throat (nasogastric tube) during surgery and may remain for a few days. Small, frequent feedings are recommended.

Follow-up care is important to monitor healing and ensure symptom relief. Patients may also review our post-surgical recovery guidelines for additional support.

1. What is a hiatal hernia?
   A hiatal hernia occurs when part of the stomach pushes up through the diaphragm into the chest cavity, often causing reflux and swallowing issues.
2. What symptoms are commonly associated with a hiatal hernia?
   Common symptoms include chronic heartburn, acid reflux, chest discomfort, difficulty swallowing, regurgitation, and sometimes shortness of breath.
3. When is hiatal hernia surgery necessary?
   Surgery is recommended when symptoms are severe, persistent, or do not respond to medications and lifestyle changes.
4. Can a hiatal hernia be treated without surgery?
   Mild cases may be managed with medications and dietary changes, but surgery is often the most effective long-term solution for severe or complicated cases.
5. How is hiatal hernia repair performed?
   The procedure involves returning the stomach to its proper position, tightening the diaphragm opening, and often performing a fundoplication to reduce reflux.
6. Is hiatal hernia repair done laparoscopically?
   Yes. Most hiatal hernia repairs in Orange County are performed using minimally invasive laparoscopic techniques for faster recovery and less pain.
7. What is fundoplication, and why is it performed?
   Fundoplication involves wrapping the upper part of the stomach around the esophagus to strengthen the valve and prevent acid reflux.
8. How long does hiatal hernia surgery take?
   The procedure typically lasts between two and three hours, depending on the complexity of the hernia.
9. How long is the hospital stay after hiatal hernia repair?
   Patients usually stay in the hospital for several days to allow proper monitoring and recovery.
10. Is hiatal hernia surgery painful?
    Some discomfort is expected after surgery, but pain is generally well controlled with medication and improves steadily during recovery.
11. What is recovery like after hiatal hernia repair?
    Recovery includes gradual return to normal activities, dietary adjustments, and follow-up visits to ensure proper healing.
12. Will I need to follow a special diet after surgery?
    Yes. Patients are usually advised to eat small, frequent meals and follow a soft or liquid diet initially during recovery.
13. What risks are associated with hiatal hernia repair?
    Risks are uncommon but may include infection, bleeding, difficulty swallowing, or recurrence of the hernia.
14. Can a hiatal hernia come back after surgery?
    Recurrence is uncommon when the repair is performed correctly, but long-term follow-up helps monitor results.
15. Do I need a consultation for hiatal hernia repair in Orange County?
    Yes. A consultation allows your surgeon to evaluate symptoms, review imaging, and determine whether surgery is the best option for you.