Hiatal hernia and reflux surgery

Hiatal hernia and reflux surgery is the most frequent surgery performed for the benign stomach disorders. Hiatal hernia and reflux is in fact two distinct disorders but treatments are similar and therefore they are referred together.

Hiatal hernia is the displacement of stomach towards the thoracic cavity. It may cause complaints such as impingement of upper part of stomach develops and severe pain, taste of acid in the mouth, cardiac passion and heartburn. It may sometimes show no symptom, it can be identified during the endoscopy. Hiatal hernia may cause the deterioration of the valve between the stomach and esophagus and gastric acid may reach to the esophagus even throat and it may cause epigastric burning. Gastric acid moves up into the esopgahus and it is called acid reflux. Gastric acid is very strong and internal surface of the stomach is resistant to it. However, esopgahus is not. When the acid moves up into the esophagus every time, damage occurs. This is called Barrett’s esophagus. If this damage persists, it may cause cancer.

What is the reason of acid reflux?

There is not only one answer of this question. There are more than one causes found. Some people are born with a weak valve. Fatty and spicy food, some types of medicines, narrow clothes, smoking, alcohol, strong exercise or body position shifts (leaning or stretching out) cause loosening of valve and acid reflux, accordingly. Complaints increases by the position of lying at night and couching starts.

How is the acid reflux treated?

Acid reflux can be treated in three stages.

  1. Life style changes: change of eating habits may reduce the complaints in many patients especially complaints of who are fewer. Losing weight, giving up smoking and alcohol, changing eating and sleep routine can help.
  2. Medication: When changes of life style are not sufficient, medication should be administered. Medicines reducing the acid production and anti-acids can be used. You should use medicine as prescribed by your physician.
  3. Surgical treatment: If medication and life style changes are not sufficient and in the presence of hiatal hernia, surgical treatment is administered. Surgical treatment is very effective in the acid reflux treatment. Commonly used method in the world is Nissen fundoplication surgery. In this surgery, stomach extending to the top part is retracted to the abdominal cavity and upper part of the stomach is wrapped around the valve. Accordingly, valve is reinforced and gastric acid does not flow upwards. Open and laparoscopic (closed) methods are employed. While in the open method, an incision from the thoracic cage to the navel is applied, 1-2 cm 5 openings are used to access in the closed method.

What is the advantage of the laparoscopic surgery?

  • Less post-operative pain
  • Shorter term of hospitalization
  • Quicker return to the normal life.
  • Fewer scars

Am I eligible for the laparoscopic surgery?

Laparoscopic method has a number of advantages compared to the open surgery. However, every patient may not undergo laparoscopic reflux surgery. The patient should be evaluated by considering his previous operations and present diseases.

What will happen in the post-laparoscopic operation period?

  • You can do light exercises at home after discharging. Lifting heavy load or tiring activities are not recommended in the earlier period.
  • Post-op pain is generally low. Patients do not generally use pain killers.
  • Anti-reflux medicines are not generally necessary.
  • You will begin a special diet. You will start to consume liquids and then solid food gradually.
  • You will return to your normal life within 2-4 weeks.

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Obesity and Metabolic Surgery

Surgeon MD Özgün Akgül