Hiatal Hernia Surgery: Procedure, Recovery, and Outlook

Anyone experiencing acid reflux or hiatal hernia symptoms can benefit from surgery. While there are some individuals who can manage their condition with diet and lifestyle changes, hiatal hernia surgery remains the quickest and most effective treatment. Below is a brief overview of what to expect with the procedure, recovery, and outlook.

• What is hiatal hernia surgery?
• When is surgery required?
• What are the different types of surgery available for hernias?
• What is the recovery time for hiatal hernia surgery?
• How effective is hiatal hernia surgery?
• What are the complications and risks involved?
• Alternatives to hiatal hernia surgery

What Is Hiatal Hernia Surgery?

Hiatal surgery is a treatment that’s recommended for anyone experiencing heartburn, acid reflux, and other gastrointestinal symptoms. Surgery is the most effective treatment option for hiatal hernias.

When Is Hiatal Hernia Surgery Required?

Surgery is not recommended for everyone who has a hiatal hernia. Many people are asymptomatic, meaning they don’t have symptoms and are probably unaware they have a hernia.

Others occasionally experience symptoms but not regularly or serious enough to seek out medical care. Surgery is ideal for individuals with mild to severe symptoms, or GERD (gastroesophageal reflux disorder) and whose condition is not treatable with medications or lifestyle changes.

What Are the Different Types of Surgery Available for Hernias?

Hiatal hernia surgery is usually performed laparoscopically. However, some patients may require open hiatal hernia surgery due to a prior medical history of abdominal surgery, recurrent hernias, and other concerns. Open hiatal hernia surgery is also the standard for emergency hernia repairs.

Hiatal hernia surgery is performed in three ways: open, endoluminal, and Nissen fundoplication. Each procedure takes approximately two to three hours, sometimes longer to complete. General anesthesia is required.

Open hernia surgery is the most invasive of the three procedures. After making one large incision to the abdomen, the surgeon opens the cavity so he can inspect the hernia and nearby tissues. He then adjusts repositions the stomach to put it back in place before wrapping a portion of it around the esophagus. Wrapping the stomach around the esophagus is necessary to tighten the sphincter seal to prevent acid reflux and other hiatal hernia-related symptoms. Some patients may also have a tube installed that must be surgically removed after a few weeks.

Laparoscopic hiatal hernia repair surgery is minimally invasive and offers patients a significantly shorter recovery than open surgery. The surgeon makes several small incisions in the stomach and inserts small, surgical instruments to perform the procedure. One of these devices is a laparoscope, which is a small tube-like instrument with an attached light and camera that transmits real time images of the patient’s insides to a screen so the surgeon can see and complete the operation. The rest of the procedure is similar to open hernia surgery repair.

Robotic-assisted hiatal hernia surgery is very similar to the laparoscopic method, but instead Dr. Khosravi performs the operation directly by console, utilizing the da Vinci Robotic Surgery system. The results are better outcomes, less surgical trauma and injury, and faster recoveries for patients.

What Is the Recovery Time for Hiatal Hernia Surgery?

Recovery time for hiatal hernia surgery is dependent on the procedure type. Usually, patients take anywhere from 10 to 12 weeks to completely recover. However, many patients heal faster and are back to their normal routines sooner. Of course, laparoscopic, and robotic-assisted surgery patients require less time to recover. The average time for minimally invasive hiatal hernia recovery is six to eight weeks. Each patient recovers differently.

How Effective Is Hiatal Hernia Surgery?

Hernia repair surgery is over 90 percent effective at repairing hernias. Although there is an extremely low risk of hernia recurrence, patients who have subsequent procedures have over an 80% success rate at symptom relief.

What Are the Complications and Risks Involved?

There are risks with surgery, including hiatal hernia surgical repairs. The following complications can occur:

• Bleeding
• Bloating
• Diarrhea
• Nausea or vomiting
• Trouble swallowing
• Nausea
• Hernia or acid reflux recurrence
• Infection
• Organ damage

These risks and complications are much lower with laparoscopic and robotic hernia repair than open/traditional surgery.

Alternatives to Hiatal Hernia Surgery

Surgery is best as a last resort for those with occasional symptoms or who are asymptomatic. Initial and alternatives to hiatal hernia surgery include the following therapeutics:

Medications to help neutralize stomach acid production and reduce gastric acid activity (H-2 blockers) provide temporary relief for some individuals. Proton pump inhibitors are also effective at reducing gastric acid production. However, long-term use is not advised and can lead to other medical concerns. There are over-the-counter and prescription options.

Lifestyle changes that help alleviate symptoms and provide relief are eating several small meals throughout the day, avoiding certain foods and beverages, exercising and maintaining a healthy weight, and eating no less than three hours before going to bed. Smoking cessation, sleeping in an elevated position, and avoiding tight fitting clothing are also very beneficial for hiatal hernia symptom management.

Key Takeaways

Hiatal hernias are common and, in some cases, are asymptomatic. Individuals experiencing acid reflux and heartburn more than a few times a week or symptoms that worsen should seek out treatment, which may include surgery. Hiatal hernia surgical repair is often necessary to stop symptoms and prevent complications. Surgery is safe and highly effective and is available as a laparoscopically, robotic-assisted, and open procedure.

Not everyone who qualifies for surgery is suitable for laparoscopic or robotic-assisted treatment although they are less invasive, and patients recover quickly from them. Open hiatal surgery is reserved for certain cases based on the surgeon’s recommendations.

Individuals with mild symptoms may manage their condition with medication and or changes to their lifestyle and diet. Eventually, surgery is required to prevent progression and additional medical concerns.

If you are experiencing hernia pain, acid reflux or heartburn, contact Orange County Robotic General Surgery for treatment.

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