Laparoscopic anterior
If you or an elderly loved one needs hernia repair surgery, there's no need to worry. Modern medical technology and surgical practices have evolved tremendously over the last few years, so patients of all ages have better outcomes after surgery.
Possible long-term complications that can result in recurrent or new symptoms include hiatal hernia recurrence, fundoplication disruption, fundoplication slippage, or post-surgical gastroparesis. Another group of patients that require routine post-operative imaging are patients who have Barrett's esophagus.
The most common complications are difficulty swallowing, abdominal bloating, diarrhea, and nausea. Most patients can't belch as well as they could before surgery, although the inability to belch is distinctly uncommon. About 25% of patients can't vomit after surgery.
Mortality rate following an elective open hiatal hernia repair has been quoted at 1.0-2.7%. Laparoscopic elective repairs have mortality rates as low as 0.57%.
Surgery is often recommended for large hiatal hernias that cause serious symptoms that are not controlled with medication. Occasionally these hernias can become emergency operations if the stomach twists and causes an obstruction or ischemia (lack of blood flow) to the stomach.
The risks of a hiatal hernia repair include: Internal bleeding. Infection. Damage to nearby organs.
When is surgery required? Most hiatal hernias do not cause symptoms, and therefore, treatment is not usually necessary. Those who have more mild symptoms, such as heartburn, acid reflux, or gastroesophageal reflux disorder (GERD), may be able to treat their condition with medications or lifestyle changes.
How long does laparoscopic hiatal hernia repair take? The surgery itself takes 2 to 2.5 hours.
Laparoscopic surgery is a safe surgery. But all surgeries have risks. The risks of a hiatal hernia repair include: Internal bleeding.
A new technique for treatment
"Using robotic and minimally invasive techniques, the upper stomach is shaped into a tubular structure that performs as if it were an esophagus and allows the stomach and fundoplication to remain below the diaphragm. This intervention reduces the risk the hernia will recur," says Burch.
Returning to normal may take a few weeks or even months, depending on your body's healing power. Most patients feel much better once they are able to eat and enjoy life without a hiatal hernia.
As discussed above, endoscopic reduction with percutaneous endoscopic gastrostomy (PEG) gastropexy, by providing 2-point fixation of stomach to the abdominal wall, can be a safe and effective alternative to surgery in treating gastric volvulus and hiatal hernia in patients who are poor surgical candidates.
In general, the older patient will have a longer recovery time than a younger patient and is expected to have more complications. In short, the elderly surgery patient will require more support than a younger one, from both professional healthcare providers and other individuals in their family and social circles.
You and your doctor may want to put off surgery if: The hernia is small and you don't have any symptoms, or if the symptoms don't bother you much. The hernia can be pushed back into the belly or it goes away when you lie down. (If it cannot be pushed back, surgery must be done sooner.)
Satisfaction with surgery was 97% during early and 93.3% during late post-operative follow up. Laparoscopic repair of GHH in appropriately selected elderly patients is safe and results in significant improvement in quality of life.
In most cases, hiatal hernia surgery is performed while you're asleep under general anesthesia.
Activity. There are no significant restrictions on activity after surgery. That means it is OK to walk, climb stairs, have sexual intercourse, mow the lawn, or exercise as long as it doesn't hurt. In fact, returning to normal activity as soon as possible will most likely enhance your recovery.
You may be able to go home the same day after laparoscopic surgery. Recovery time after hiatal hernia surgery is typically 6-8 weeks. However, this can vary depending on your general health status and healing process.
Treating a hiatus hernia
Treatment for a sliding hiatus hernia usually focuses on relieving the symptoms of GORD, such as heartburn. Lifestyle changes and medication are the preferred treatments. Surgery is usually only recommended as an alternative to long-term medication or if other treatments haven't worked.
therefore determined that hiatal hernias less than or equal to 2 cm were not clinically significant and should not count as a recurrence. They advocated for repair of all symptomatic recurrent hernias greater than 2 cm.
Large hiatal hernia can cause extensive posterior cardiac compression including frequent compression of the basal inferior left ventricular wall, with such changes resolving post hernia repair. The implications of hiatal hernia–induced cardiac distortion on arrhythmia pathogenesis are poorly recognized.
If hernia is left untreated, the size of protruding intestine might get bigger and become strangulated leading to the reduction of blood flow to surrounding tissue.