Hiatal Hernia

Esophagus passes through an opening in the diaphragm (i.e. hiatus) on its way to connect to the stomach. Hiatal hernias occur when the muscle tissue surrounding hiatus becomes weak, causing the bulging of the upper part of the stomach through the diaphragm into the chest cavity. It is generally caused due to obesity, pregnancy, aging, or thinning of the phrenoesophageal membrane

Symptoms of Hiatal Hernia

A small hiatal hernia generally does not cause any symptom and need no treatment. But an enlarged hernia can cause following symptoms:

Heartburn - 30 - 60 minutes after eating

Regurgitation of stomach contents that gets worsened with lying flat

Excessive belching

Aspiration (reflux of stomach contents into the airway)

Recurrent Asthma attack’s

Pain or burning in chest

Difficult or painful swallowing

Vomiting blood or passing black stools

Diagnosis of Hiatal Hernia

It is often diagnosed while diagnosing the reason of heartburn or chest or upper abdominal pain by performing following evaluations:

Physical examination

Esophagram (barium swallow)

Upper endoscopy

Esophageal manometry

H metry & Impedence ( if required)

Laparoscopic Cruroplasty and Nissen fundoplication for Hiatal Hernia

Laparoscopic Cruroplasty and Nissen fundoplication is the procedure of choice for repair of a symptomatic as well as asymptomatic hiatal hernia.The laparoscopic Cruroplasty and Nissen fundoplication is performed through five quarter-inch incisions. Laparoscope and other instruments are inserted through these incisions. The hernia is reduced from the chest into the abdomen. This may require separation of abdominal organs from the lung and middle chest structures. This is followed by repair of hiatus to its appropriate size and construction of a new lower esophageal valve. Prosthetic material is used in cases of large hernias with poor tissue to prevent recurrence. The procedure takes about two to four hours depending on the size and contents of the hern

Advantages of Laparoscopic Cruroplasty and Nissen fundoplication for Hiatal Hernia Repair

Faster recovery

overnight hospitalization

Sooner return to work

Very less pain during and after the procedure

Smaller incisions without any cut on abdominal muscles

Negligible risks and complications

Less chances of wound infection

High success rate with more than ninety-percent of symptom free patients after ten years of the procedure.

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