Introduction
Hiatal hernia surgery is a common procedure performed to address the symptoms associated with a hiatal hernia, such as severe acid reflux or GERD. In this article, we will explore the purpose of the surgery, preparation required, the procedure itself, the recovery process, and the outlook for individuals who undergo this surgery.
Hiatal Hernia Surgery: Understanding the Purpose
The primary goal of hiatal hernia surgery is to repair the hernia by repositioning the stomach back into the abdomen and reducing the size of the diaphragmatic opening. In some cases, the procedure may involve reconstructing the esophageal sphincter or removing hernial sacs. It is important to note that not all individuals with a hiatal hernia require surgery. Typically, surgery is recommended for those with severe cases that have not responded well to other treatment options.
Preparing for Hiatal Hernia Surgery: What to Expect
Your doctor will provide you with detailed instructions on how to prepare for the surgery. This may include activities such as regular walking, breathing exercises, and discontinuing certain medications like clopidogrel (Plavix) and nonsteroidal anti-inflammatory drugs (NSAIDs). While a clear liquid diet is usually not necessary, it is important to abstain from eating or drinking for at least 12 hours prior to the surgery.
The Procedure: Techniques and Approaches
Hiatal hernia surgery can be performed using different techniques, including open repairs, laparoscopic repairs, and endoluminal fundoplication. These procedures are typically performed under general anesthesia and take approximately 2 to 3 hours to complete.
Open Repair
Open repair is a more invasive approach compared to laparoscopic repair. It involves making a large surgical incision in the abdomen to access the herniated area. The surgeon then repositions the stomach and wraps it around the lower portion of the esophagus to create a tighter sphincter. In some cases, a tube may be inserted to maintain proper positioning, which will be removed within a few weeks.
Laparoscopic Repair
Laparoscopic repair is a minimally invasive technique that offers faster recovery and a lower risk of infection. It involves making several tiny incisions in the abdomen through which specialized surgical instruments are inserted. Guided by a laparoscope, which provides visual guidance through a monitor, the surgeon repositions the stomach and wraps the upper part around the lower esophagus, creating a tighter sphincter to prevent reflux.
Endoluminal Fundoplication
Endoluminal fundoplication is a newer, less invasive option. No incisions are made during this procedure. Instead, an endoscope with a lighted camera is inserted through the mouth and into the esophagus. Small clips are then placed at the junction of the stomach and esophagus to prevent the backflow of stomach acid and food.
Recovery Process: What to Expect
During the recovery period, you will be provided with appropriate medications that should be taken with food. Some temporary discomfort, such as tingling or burning pain near the incision site, is common but can be managed with over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen. It is important to gently cleanse the incision area daily with soap and water, avoiding baths, pools, or hot tubs and sticking to showering only.
A restricted diet is typically recommended to prevent stomach extension. This involves consuming smaller, more frequent meals (4 to 6 per day) instead of three large meals. The post-surgery diet usually begins with a liquid phase, gradually progressing to soft foods such as mashed potatoes and scrambled eggs.
Certain foods and behaviors should be avoided during the recovery period, including drinking through a straw, gas-inducing foods like corn and beans, carbonated drinks, alcohol, citrus fruits, and tomato products. Your doctor will likely provide breathing and coughing exercises to strengthen the diaphragm, which should be performed daily as instructed.
Early mobilization through regular walking is crucial to prevent blood clot formation in the legs. While the full recovery period can take 10 to 12 weeks, it is important to note that resumption of normal activities can occur sooner, depending on individual circumstances.
Outlook for Hiatal Hernia Surgery
Following the recovery period, the symptoms of heartburn and nausea should significantly improve. However, it is still recommended to avoid trigger foods and beverages that may exacerbate GERD symptoms, such as acidic foods, carbonated beverages, and alcohol. Your doctor will provide specific recommendations tailored to your individual needs to ensure long-term success and management of hiatal hernia symptoms.
Conclusion
Hiatal hernia surgery is an effective treatment option for individuals with severe cases that have not responded well to other treatments. With proper preparation, skilled surgical techniques, and adherence to post-surgery guidelines, individuals can expect a successful recovery and improved quality of life. It is important to consult with a healthcare professional to determine the best course of action for your specific condition.
