A hiatal hernia occurs when the upper part of the stomach and esophagus slide through an opening in the diaphragm and up into the chest. This opening is called the hiatus. This commonly allows the lower esophageal sphincter muscle (LES) to fail in the low pressure environment of the chest, which then results in heartburn/reflux (GERD).
Paraesophageal hernias occur when part of the stomach is twisted and squeezed up into the chest beside the esophagus. Patients with this problem usually do not have reflux but complications can occur such as incarceration or strangulation. Incarceration is common and occurs when the stomach is stuck and is being squeezed by its tight position. This results in severe chest pain, difficulty swallowing, indigestion, nausea and vomiting. Strangulation is a surgical emergency and occurs when the blood supply to the stomach is so twisted that it is cut off. This can lead to death of the stomach and can be life threatening.
REPAIR of HIATAL DEFECT and NISSEN FUNDOPLICATION - closure of diaphragmatic defect (+/- mesh) and wrapping the upper segment of the stomach (fundus) around the lower end of the esophagus to strengthen it.
Surgery is normally performed:
ROBOTICALLY has key advantages for patients including:
- Less post-operative pain
- Faster recovery from surgery
- Shorter hospital stay
- Quicker return to work and normal activities
- Improved cosmetic result
