Hiatus Hernia and benefits of Surgical Intervention
When the internal body parts or tissue protrude through a weak muscle wall (commonly seen in the abdominal and groin areas), it is referred to as a hernia. It is of different types and is categorised based on the location in which it occurs. Of all the hernia types, the most common one is hiatal hernia.
Hiatal hernia is a condition where a portion of your stomach is pushed up through the diaphragm into the chest cavity. The diaphragm is a big and strong muscle that acts as a barrier between the abdomen and chest cavities. There is a small opening in this diaphragm, which is called a hiatus. The oesophagus, which is used to swallow food, passes through this hiatus before it reaches the stomach. In the case of this hiatal hernia, your stomach is pushed up through the opening of the hiatus into the chest cavity.
Usually, small hiatal hernias are not harmful, and you may not even know that you have one. However, if the hiatal hernia is large, it leads to complications like allowing food and acid reflux back into your esophagus. This may result in heartburn. Symptoms of this hernia can be relieved with the help of medicines and certain self-care measures. But in the case of a large hiatal hernia, surgery might be the best treatment option.
If you are considering surgical treatment for hiatal hernia, then you must know about sliding hiatal hernia and paraesophageal hernia, the two major types of hiatus hernias.
Sliding hiatal hernia: This is the most common hernia type in which the upper portion of the stomach and the lower esophagal part push upward through the diaphragm into the chest cavity.
Paraesophageal hernia: This is less common but can be more severe; in this type of hernia, a portion of the stomach slides up and sits beside the oesophagus. As the condition becomes severe, the slid-up portion of the stomach becomes strangulated and loses blood supply if not treated.
How common are hiatal hernias?
Hiatal hernias are more commonly observed in older people. The prevalence of this condition is becoming more common in India due to a sedentary lifestyle that leads to obesity and gastro-oesophageal reflux disease (GERD).
Some studies say that hiatal hernia affects 10-15% of the general population, but most of the cases go undiagnosed because small hiatal hernias are asymptomatic.
Some studies say that, in India, around 30-40% of people with GERD condition tend to have a hiatal hernia. The number of GERD and obesity cases is swiftly increasing in India, which suggests that cases of hiatal hernias are also becoming more frequent.
When is surgery necessary for a hiatus hernia?
Generally, surgical interventions for a hiatus hernia are suggested in the following cases:
- Chronic GERD, which is unresponsive to medications and lifestyle changes.
- Esophagal inflammation (caused by prolonged acid reflux)
- Strangulation.
- Having swallowing problems due to large hernia (dysphagia).
- Severe chest pain or breathing problems
Surgical treatment is often necessary in these cases.
Surgical treatment for hiatus hernia
Multiple surgical techniques are available to repair a hiatus hernia, as mentioned below.
Laparoscopic Nissen Fundoplication
This is the common minimally invasive procedure used to treat hiatus hernia. The procedure involves making a few small incisions in the upper abdomen and inserting a laparoscope with a light-headed camera, which gives visuals to the surgeon and other surgical instruments to repair the hernia.
The surgeon pushes the stomach back into its place and wraps the fundus (the stomach’s upper portion) around the lower oesophagus to reduce acid reflux and prevent recurrence.
Laparoscopic paraesophageal hernia repair
It is also a laparoscopic procedure. However, in this procedure, sutures are used to tighten the hiatus in addition to repositioning the stomach. The sutures tighten the diaphragm and help to prevent recurrence.
Often, surgeons use synthetic mesh to provide stability while repairing large hernias or when the diaphragm muscles are weak.
Open surgery
This has become a rare surgical procedure these days and is used to repair complex hernias. During this procedure, the surgeon makes a large single incision in the abdomen to gain access to and repair the hernia.
Transoral Incisionless Fundoplication (TIF)
Relatively, this is a new minimally invasive surgical technique introduced in 2006. This is an innovative procedure as it does not require making any incisions and is performed through the mouth. This is a very effective treatment option for small sliding hiatus hernias.
Benefits of Hiatus Hernia Surgery
For people who are suffering from hiatus hernia, surgery offers substantial benefits, especially when conservative treatment options are unresponsive. Here’s a look at the key advantages:
- Provides relief from annoying symptoms like chronic acid reflux and GERD
- Prevents life-threatening complications like strangulation of the stomach caused by paraesophageal hernias.
- Following surgery, people find relief from chest pain, heartburn, and other problems caused by the hernia.
- In the case of minimally invasive procedures, there is less postoperative pain, and recovery will be quick.
- Improves quality of life
- Restores digestive functions and the risk of complications like oesophagitis or Barrett’s oesophagus will be reduced
- Provides long-term relief as the recurrence rate of hernia is less with the procedure
Experts say that laparoscopic Nissen fundoplication surgery has a 90% to 95% success rate in relieving GERD symptoms caused by hernia. The National Health Service (NHS) says that around 80%–85% of people have long-term relief from symptoms following surgery.
If you have any hernia problems and are looking for the best laparoscopic hernia surgeon in Hyderabad, consult Dr. Venugopal Pareek. Call +91 91777 77715 for appointments.
