Laparoscopic Hiatal Hernia Repair
Laparoscopic Hiatal Hernia Repair
A hiatal hernia occurs when part of the stomach moves upwards into the chest through the esophageal gap in the diaphragm. Factors that contribute to the development of hiatal hernia and enlargement of the esophageal hiatus include growth defects, increased abdominal pressure, and a decrease in the elastic fibers of the hiatal membrane with age. Not everyone with a hiatal hernia needs surgery. Many people may be able to manage the condition with medication or lifestyle changes. If the hernia is causing severe symptoms or is likely to cause complications, the person may need surgical intervention which is laparoscopic hiatal hernia repair with Dr. Ahmed Abd El Salam, Assistant Professor of General and Laparoscopic Surgery and Consultant for Bariatric Surgery, Faculty of Medicine at Kasr El-Ainy.
Since a hiatal hernia often does not cause serious symptoms, the first evidence of the hernia may appear on a chest X-ray that may be ordered to diagnose another issue.
Diagnosing a hiatal hernia and distinguishing it from gastritis:
Since both diseases cause the same symptoms of reflux, heartburn, and vomiting, Dr. Ahmed Abd El Salam, Assistant Professor of General and Laparoscopic Surgery and Consultant for Bariatric Surgery, Faculty of Medicine at Kasr El-Ainy, performs some tests to differentiate between the two conditions and reaches an accurate diagnosis among the most important ones:
1- A flexible scope, called an endoscope, is inserted through the mouth to obtain live images of the esophagus, stomach, and duodenum, which is the first part of the small intestine. The endoscope shows whether there is a hiatal hernia or a misplaced stomach.
2- A barium scan requires drinking approximately 1.5 cups of a specific liquid and, after about 30 minutes, undergoing a series of X-rays. More recently, this procedure has been replaced by CT scans.
3- In the case of a decision to perform surgical intervention, esophageal manometry and pH monitoring are conducted.
Pharmacological treatment of hiatal hernia symptoms:
People may be able to minimize the symptoms of a hiatal hernia by using certain medications, but these do not treat the hernia itself. which are as follows:
• Antacids: Antacid medications usually neutralize stomach acid. However, overuse should be avoided as it can cause severe diarrhea or kidney problems.
• H2 receptor blockers: These medications typically reduce the production of stomach acid.
• Proton pump inhibitors (PPIs): These drugs tend to block acid production for longer periods than H2 receptor blockers, giving the esophageal tissue more time to heal.
In the case of relying on medication and its success in controlling symptoms, regular follow-up with endoscopy is essential. Dr. Ahmed Abd El Salam recommends performing endoscopy after one year, then after three years, and then after five years.
Dr. Ahmed Abd El Salam's tips for hiatal hernia patients:
Some people can find relief from reflux symptoms by making the following lifestyle changes:
• Maintain a moderate weight.
• Eat five to six small meals a day instead of three large ones.
• Avoid foods that cause acid reflux, including fried foods, acidic foods, alcohol, and caffeine.
• Eat the last meal of the day at least three hours before bedtime.
• Smoking cessation.
• Elevate your head position when lying down to prevent acid reflux during sleep.
• Wear loose clothing to prevent pressure on the abdomen.
When is surgical laparoscopy required?
People may be able to treat moderate hiatal hernia symptoms, such as heartburn, reflux, indigestion, and vomiting with medication or lifestyle changes as mentioned above. But if these conservative methods don't work, laparoscopic surgery may provide long-term relief from reflux. This procedure is usually minimally invasive and has a high success rate and quick recovery.
Since a hiatal hernia often does not cause serious symptoms, the first evidence of the hernia may appear on a chest X-ray that may be ordered to diagnose another issue.
Diagnosing a hiatal hernia and distinguishing it from gastritis:
Since both diseases cause the same symptoms of reflux, heartburn, and vomiting, Dr. Ahmed Abd El Salam, Assistant Professor of General and Laparoscopic Surgery and Consultant for Bariatric Surgery, Faculty of Medicine at Kasr El-Ainy, performs some tests to differentiate between the two conditions and reaches an accurate diagnosis among the most important ones:
1- A flexible scope, called an endoscope, is inserted through the mouth to obtain live images of the esophagus, stomach, and duodenum, which is the first part of the small intestine. The endoscope shows whether there is a hiatal hernia or a misplaced stomach.
2- A barium scan requires drinking approximately 1.5 cups of a specific liquid and, after about 30 minutes, undergoing a series of X-rays. More recently, this procedure has been replaced by CT scans.
3- In the case of a decision to perform surgical intervention, esophageal manometry and pH monitoring are conducted.
Pharmacological treatment of hiatal hernia symptoms:
People may be able to minimize the symptoms of a hiatal hernia by using certain medications, but these do not treat the hernia itself. which are as follows:
• Antacids: Antacid medications usually neutralize stomach acid. However, overuse should be avoided as it can cause severe diarrhea or kidney problems.
• H2 receptor blockers: These medications typically reduce the production of stomach acid.
• Proton pump inhibitors (PPIs): These drugs tend to block acid production for longer periods than H2 receptor blockers, giving the esophageal tissue more time to heal.
In the case of relying on medication and its success in controlling symptoms, regular follow-up with endoscopy is essential. Dr. Ahmed Abd El Salam recommends performing endoscopy after one year, then after three years, and then after five years.
Dr. Ahmed Abd El Salam's tips for hiatal hernia patients:
Some people can find relief from reflux symptoms by making the following lifestyle changes:
• Maintain a moderate weight.
• Eat five to six small meals a day instead of three large ones.
• Avoid foods that cause acid reflux, including fried foods, acidic foods, alcohol, and caffeine.
• Eat the last meal of the day at least three hours before bedtime.
• Smoking cessation.
• Elevate your head position when lying down to prevent acid reflux during sleep.
• Wear loose clothing to prevent pressure on the abdomen.
When is surgical laparoscopy required?
People may be able to treat moderate hiatal hernia symptoms, such as heartburn, reflux, indigestion, and vomiting with medication or lifestyle changes as mentioned above. But if these conservative methods don't work, laparoscopic surgery may provide long-term relief from reflux. This procedure is usually minimally invasive and has a high success rate and quick recovery.
The doctor may recommend surgical intervention in the following cases:
• Symptoms are severe and interfere with normal life.
• Symptoms do not respond to conservative treatments, whether lifestyle changes or pharmacological therapy.
• A hernia is at risk of strangulation, which is when the blood supply to the herniated tissue is cut off, a condition that can be fatal.
• Symptoms include bleeding, ulcers, or narrowing of the esophagus.
Details of the laparoscopic hiatal hernia repair:
This surgery is minimally invasive and requires only a few small incisions in the abdomen. Dr. Ahmed Abd El Salam inserts a laparoscope, a thin tube with a light and camera, into the abdomen. The surgeon pulls the stomach back into its normal position within the abdominal cavity and wraps the stomach around itself, so it doesn't go back into the chest cavity.
• Symptoms are severe and interfere with normal life.
• Symptoms do not respond to conservative treatments, whether lifestyle changes or pharmacological therapy.
• A hernia is at risk of strangulation, which is when the blood supply to the herniated tissue is cut off, a condition that can be fatal.
• Symptoms include bleeding, ulcers, or narrowing of the esophagus.
Details of the laparoscopic hiatal hernia repair:
This surgery is minimally invasive and requires only a few small incisions in the abdomen. Dr. Ahmed Abd El Salam inserts a laparoscope, a thin tube with a light and camera, into the abdomen. The surgeon pulls the stomach back into its normal position within the abdominal cavity and wraps the stomach around itself, so it doesn't go back into the chest cavity.
Laparoscopic repair has several advantages including:
• Lower risk of infection.
• less painful.
• Fewer scars.
• The time spent in the hospital is shorter.
• Less recovery time.
Details on recovery time:
After laparoscopic surgery, most people usually don't experience much pain, but they may experience abdominal and chest discomfort, short-term difficulty swallowing, and a feeling of fullness. These symptoms gradually improve over time.
After laparoscopy, you may go home the same day or spend one night in the hospital and can usually walk around the day after surgery.
In the days following surgery, Dr. Ahmed Abd El Salam usually advises the patient to do the following:
• Avoid using swimming pools and hot tubs.
• Walk whenever possible to prevent blood clots in the leg.
• Avoid drinking through a straw.
• Practice specific breathing exercises to strengthen the diaphragm.
In the weeks after the procedure, the following is recommended:
• Follow a specific diet after surgery, including drinking clear liquids immediately after surgery and switching to soft or liquid foods, including mashed potatoes, juices, and soups the next day. It is also important to avoid foods that cause gas and bloating.
• Take pain relief medication for several days after surgery to minimize discomfort.
• Avoid driving for 7-10 days.
• Return to work when you feel well enough.
• Avoid lifting any heavy objects for 2-3 weeks.
• Eat small meals during the day instead of three large meals.
Most people can return to their usual diet within 3 to 6 weeks after surgery. However, even after a person has fully recovered, Dr. Ahmed Abd El Salam may recommend continuing to limit or avoid foods that contribute to gas, bloating, and acid reflux symptoms, such as:
• Acidic foods, including citrus fruits and tomato products.
• Alcohol.
• Beans and lentils.
• Fizzy drinks.
• Corn cereal.
• Broccoli and cauliflower.
• Fried foods.
• Caffeine.
Laparoscopic hiatal hernia repair with Dr. Ahmed Abd El Salam, Assistant Professor of General and Laparoscopic Surgery and Consultant for Obesity Surgery, Faculty of Medicine at Kasr El-Ainy, is the best option to improve your symptoms. With his extensive experience and advanced skills in laparoscopic surgery, you can expect excellent care and results.
• Lower risk of infection.
• less painful.
• Fewer scars.
• The time spent in the hospital is shorter.
• Less recovery time.
Details on recovery time:
After laparoscopic surgery, most people usually don't experience much pain, but they may experience abdominal and chest discomfort, short-term difficulty swallowing, and a feeling of fullness. These symptoms gradually improve over time.
After laparoscopy, you may go home the same day or spend one night in the hospital and can usually walk around the day after surgery.
In the days following surgery, Dr. Ahmed Abd El Salam usually advises the patient to do the following:
• Avoid using swimming pools and hot tubs.
• Walk whenever possible to prevent blood clots in the leg.
• Avoid drinking through a straw.
• Practice specific breathing exercises to strengthen the diaphragm.
In the weeks after the procedure, the following is recommended:
• Follow a specific diet after surgery, including drinking clear liquids immediately after surgery and switching to soft or liquid foods, including mashed potatoes, juices, and soups the next day. It is also important to avoid foods that cause gas and bloating.
• Take pain relief medication for several days after surgery to minimize discomfort.
• Avoid driving for 7-10 days.
• Return to work when you feel well enough.
• Avoid lifting any heavy objects for 2-3 weeks.
• Eat small meals during the day instead of three large meals.
Most people can return to their usual diet within 3 to 6 weeks after surgery. However, even after a person has fully recovered, Dr. Ahmed Abd El Salam may recommend continuing to limit or avoid foods that contribute to gas, bloating, and acid reflux symptoms, such as:
• Acidic foods, including citrus fruits and tomato products.
• Alcohol.
• Beans and lentils.
• Fizzy drinks.
• Corn cereal.
• Broccoli and cauliflower.
• Fried foods.
• Caffeine.
Laparoscopic hiatal hernia repair with Dr. Ahmed Abd El Salam, Assistant Professor of General and Laparoscopic Surgery and Consultant for Obesity Surgery, Faculty of Medicine at Kasr El-Ainy, is the best option to improve your symptoms. With his extensive experience and advanced skills in laparoscopic surgery, you can expect excellent care and results.
