Paraesophageal Hernia Repair

A paraesophageal hernia is a rare and severe type of hernia that can cause serious problems with eating and digestion. Paraesophageal hernia repair is a procedure that can help reduce symptoms of this type of hernia, including any related blockages or twisting of the stomach.

Here’s more about how paraesophageal hernia repair is performed and how to request an appointment with Advanced Laparoscopic Associates to find out whether you’re an ideal candidate.

What Are the Two Types of Hiatal Hernias?

A hiatal hernia occurs when a portion of the upper stomach pushes through the hiatus and into the chest area. There are two types of hiatal hernias: a sliding hernia and a paraesophageal hernia.

Sliding Hernia

A sliding hernia is the most common type of hiatal hernia and is often a characteristic of gastroesophageal reflux disease (GERD). With a sliding hernia, the lower esophageal sphincter (LES) muscle at the base of the esophagus slides through the hiatus. Without the LES in its proper position, stomach acids can flow back into the esophagus to cause GERD symptoms, including heartburn and indigestion.

Paraesophageal Hernia

With a paraesophageal hernia, a portion or all of the upper stomach slides through the hiatus. This may occur with the LES (sometimes referred to as a paraesophageal hiatal hernia) or without the LES. This type of hernia often does not produce symptoms, but when it does, symptoms are severe and may include regurgitation, pain when eating and shortness of breath. Immediate surgery may be needed to repair a paraesophageal hernia to reduce the risk of stomach obstruction or ischemia.

Reasons You May Need Paraesophageal Hernia Repair

You may need paraesophageal hernia repair if your hernia is causing symptoms or is large enough to increase the risk for other health problems.

Here are instances in which your doctor may recommend paraesophageal hernia repair:

  • The hernia is causing your stomach and/or intestines to twist.
  • You experience chest pain, especially when eating.
  • You have difficulty swallowing.
  • You have pain in the middle upper part of your abdomen.
  • You are experiencing shortness of breath, which is usually caused by a large hernia.
  • You feel full for an excessively long period after eating.
  • Eating difficulties are causing you to lose weight unintentionally.
  • The hernia has caused you to develop a stomach ulcer.

If you have a paraesophageal hernia, your doctor can talk to you in greater detail about whether surgery is needed based on the size of the hernia and your symptoms.

How Is a Paraesophageal Hernia Repair Performed?

Paraesophageal hernia repair can be performed as a minimally invasive laparoscopic surgery that produces less scarring and a very short recovery time compared with open surgery. With laparoscopic surgery, you can usually go home on the first day after surgery, as opposed to four to five days after surgery, as is common with open surgery.

First, your surgeon will make about five small incisions on your abdominal area that each measure between one-fourth and one-half of an inch. A series of tiny instruments will be inserted through these incisions to perform the surgery, including a small fiber-optic camera called a laparoscope that projects images from the inside of your abdomen onto a screen. Your surgeon will refer to this screen to perform the surgery as carefully and precisely as possible.

Next, the part of the stomach that is bulging through your hiatus will gently be moved back into your abdominal cavity, and the diaphragm will be closed to prevent reherniation.

Paraesophageal Hernia Repair Recovery

Recovery from laparoscopic paraesophageal hernia repair usually lasts about four weeks. During this time, you will be advised to take it easy and avoid strenuous activities, including heavy lifting. You will also be asked to refrain from driving for the first two weeks, especially if you are taking painkillers that can affect your reaction time and decision-making abilities.

Shoulder pain after hernia repair is normal and is caused by the gas that was used to inflate your abdominal cavity during surgery. Your pain may last four to five days, which can often be relieved with heat, shoulder massage or walking.

Your diet for four to six weeks after paraesophageal hernia repair should consist mainly of soft and pureed foods, which is necessary to prevent any foods from getting stuck in your esophagus while it is healing. Scrambled eggs, mashed potatoes and applesauce are some of the many nutritious soft foods you can eat during this time.

Your surgeon will provide you with a complete list of post-surgical instructions to help you experience a safe and healthy recovery.

Who Needs a Paraesophageal Hernia Repair?

Consult with your doctor or a bariatric surgeon right away if you have a paraesophageal hernia that is causing symptoms. Your provider can help you determine whether hernia repair surgery is ideal for you based on the severity of your condition. With prompt treatment, you can greatly reduce your risk of any complications associated with a large or symptomatic hernia.

Advanced Laparoscopic Associates offers bariatric and general surgeries, including paraesophageal hernia repair. Contact us today to request an appointment if you want to learn more about your treatment options.

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