Laparoscopic Hiatal Hernia Repair - Procedure and Recovery

Hiatal Hernia 

Hiatal hernia is a condition wherein a part of your stomach extends up through the diaphragm and into your chest. The symptoms mentioned above can often be treated with proper medication as prescribed by your general physician. However, if that doesn’t work, you may need surgical intervention.

Before getting to the surgical approaches, the possible risks, and complications, let’s understand the anatomy. After all, everything comes back to the basics, right?

1. Less pain after the procedure
2. Significantly reduced recovery time
3. Fewer complications
4. Less Scarring

1. Most Hiatal hernias don’t even cause any visible symptoms, and therefore no treatment is necessary.
2. In mild cases, the hiatal hernia symptoms include heartburn, acid reflux, and GERD. These can often be treated with a combination of medications and lifestyle changes. 
3. However, a surgical approach is deemed necessary in the following circumstances:
4. The hiatal hernia treatment is not working.
5. When the symptoms are unbearable and impede your quality of life.
6. The hernia is at risk of becoming strangulated, meaning that the blood supply to the herniated area is cut-off, which can be fatal.
7. The hiatal hernia symptoms include bleeding, ulcers, or narrowing of the oesophagus (food pipe), also known as an oesophagal stricture.

Step 1: The surgeon begins by making 5-6 small incisions in the abdomen.

Step 2: The oesophagus is mobilised, and the diaphragm is moved posteriorly using sutures, making room for a French bougie, a cylindrical instrument used to calibrate or dilate the passage.

Step 3: When in place, the surgeon inserts a laparoscope to create a wrap and suture it to the oesophagus, to the right of the diaphragm, and at the hiatus. Simply put, a laparoscope is a thin tube that has a video camera attached to it, allowing the surgeon to view your internal organs clearly in the operating room. In addition to a laparoscope, the surgeon fills the abdomen with gas, inflating the surgical site to have better visualisation. (Post surgery, the gas is allowed to escape.)

Step 4: The bougie is then removed, and the wrap is further anchored with additional sutures or mesh.

Step 5: Finally, the trocar sites or external incisions are closed.

What About Post-Surgery Dietary Precautions?

It takes approximately 2-3 weeks after the surgery before you’ll be able to consume solid foods. You’ll be counselled by a dietary physician before being discharged from the hospital wherein you’ll be directed to start off on an all-liquid diet and slowly introduce soft foods as you recover. Also, the physician may recommend avoiding carbonated beverages throughout the recovery time.

In addition to this, you’ll be asked to refrain from the following foods in order to avoid gas, bloating, and acid reflux:-

1. Acidic foods or citrus fruits like tomato and orange
2. Alcohol
3. Beans and lentils
4. Corn
5. Broccoli, cabbage, cauliflower and basically all cruciferous vegetables.

First Follow Up Appointment

Barring any complications, your doctor will schedule the first follow-up appointment 2-3 weeks after the surgery. Your doctor will check the incision site during this session and ensure that the hernia has adequately healed.