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Laparoscopic Hiatal Hernia & Paraesophageal Repair

Written and reviewed by
MCh - Pediatric Surgery, MRCS, MS - General Surgery, Fellowship in Minimal Access Surgery(FMAS) & Reproductive Medicine, MBBS
General Surgeon, Hyderabad  •  20years experience
Laparoscopic Hiatal Hernia & Paraesophageal Repair

When a tissue or an organ gets displaced abnormally through the wall of the cavity in which it usually resides, then this condition is termed as a hernia. A hernia including stomach or intestine has become a common occurrence.

Hernias are caused by a combination of muscle weakness and strain. The actual cause of Hernia is not known however, some people are either born with an unusually large hiatus or it might occur when too much pressure is exerted on the muscles around your stomach. Obesity, aging, and smoking are the other contributing factors.

A Hiatal Hernia is a condition in which a part of the stomach protrudes through the diaphragm (muscular wall separating the chest cavity and the abdomen) into the chest. There are two types of Hiatal Hernia – Paraesophageal Hernia and Sliding Hernia. Sliding Hernia occurs when your stomach and esophagus slide in and out of your chest through the hiatus. Paraesophageal Hernia is the one where a part of the stomach passes or bulges into the chest beside the esophagus. Particularly if a Paraesophageal Hernia is large, it might slow down the food passage and cause the food to stick in the esophagus once it is swallowed. Fortunately, these types of cases are uncommon.

The treatment of every hernia depends on its size and symptoms. A surgery is recommended for the below-listed cases:

  • Incarcerated Hernia - Where the intestinal tissue gets trapped in the abdominal wall, resulting in pain and discomfort.
  • Strangulated Hernia -  If the Incarcerated Hernia is left untreated it may become Strangulated Hernia wherein the blood supply to the trapped tissue is cut off which can cause permanent damage or death.

Medical Emergency is considered when you experience nausea or vomiting, sudden pain which turns worse, or when Hernia turns red, purple or dark.

The common surgical procedure used for repair of a hiatal hernia is a Laparoscopic method. A laparoscope is a telescope-like instrument connected to a video camera, that is inserted into the abdominal cavity and the surgical video is visualized on high-resolution video monitors in the operating room. Long thin surgical instruments are inserted in the other incision and the surgeon performs the surgery by watching the monitor. This method causes less pain and speedy recovery compared to the conventional techniques. This is proved as a minimally invasive procedure where both pain and healing time is greatly reduced. Since incisions are very small during the surgery you experience less discomfort resulting in the use of lesser painkiller, which is one of the primary advantages of this procedure.

Another significant benefit of a laparoscopic procedure is that there is less risk of post-op infection owing to lesser exposure of the internal organs to any external contaminants. Since healing is so much faster the length of hospital stay required is also significantly shorter with laparoscopic surgery. This implies that you can return to your normal routine quicker as you will get discharged from the hospital on the same-day or the next-day of the surgery.

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