A hiatal hernia is generally located in the stomach area or the esophagus, the swallowing tube that connects the mouth to the stomach. This tube passes through the diaphragm, and often grows too wide, causing acids and foods from the stomach to regurgitate back up into the tube. Hiatal or hiatus is the medical name for an opening or tear. Therefore, a hiatal hernia often occurs if a small portion of the stomach is pushed up through that opening, causing symptoms such as heartburn and chest pain as well as acid reflux. A variety of treatments for hiatal hernia repair are available, including laparoscopic surgery.
Sliding hiatal hernia -This is the more common type of hiatal hernia. It occurs when your stomach and esophagus slide into and out of your chest through the hiatus. Sliding hernias tend to be small. They usually don’t cause any symptoms. They may not require treatment.
Fixed hiatal hernia - This type of hernia isn’t as common. It’s also known as a paraesophageal hernia. In a fixed hernia, part of your stomach pushes through your diaphragm and stays there. Most cases are not serious. However, there is a risk that blood flow to your stomach could become blocked. If that happens, it could cause serious damage and is considered a medical emergency.
The exact cause of many hiatal hernias isn’t known. In some people, injury or other damage may weaken muscle tissue. This makes it possible for your stomach to push through your diaphragm.
Another cause is putting too much pressure (repeatedly) on the muscles around your stomach. This can happen when: coughing, vomiting, straining during bowel movements or lifting heavy objects.
Some people are also born with an abnormally large hiatus. This makes it easier for the stomach to move through it.
Factors that can increase your risk of a hiatal hernia include: obesity, aging and smoking.
One of the most common types of hiatal hernia repair surgery is called a fundoplication. This procedure is also known as endoluminal fundoplication and Belsey or Thal fundoplication. This type of surgical procedure is common for those diagnosed with anti reflux disease. The minimally invasive laparoscopic surgical procedure utilizes very small incisions through which a cannula, or long, thin tube with a camera (called an endoscope) attached to one, is inserted into the body cavity. The surgeon is able to view the surgical field within the body via a monitor or screen in the operating theatre.
The patient is placed under general anesthesia during the procedure, which typically takes between 2 and 3 hours. The surgeon may choose one of two approaches to this type of surgery:
The surgeon repairs the hiatal hernia tear or opening with stitches or tightens the opening within the diaphragm that will prevent the stomach from bulging through it. Or, the surgeon will ensure a secure juncture between the esophagus and the diaphragm by stitching the upper part of the stomach around the end of the esophagus. This procedure will help prevent stomach acids or food from backing up into the esophagus during the digestive process.
Any individual who suffers chronic symptoms of heartburn, indigestion, acid reflux, or regurgitation of food or stomach acids back into the esophagus may benefit from some type of hiatal hernia repair procedure.Hiatal hernia repair is considered safe and effective, though case outcomes depend on individual scenarios and symptoms.
In the United States, the cost of hiatal hernia repair will depend on the type of approach utilized, hospitalization and surgeons fees, but the cost of the procedure alone averages about $5,000, though costs may increase if complications, or certain patient conditions require more in-depth procedure and time, such as for those who are overweight or obese. However, patients traveling to destinations such as India, Mexico or Argentina may enjoy all-inclusive benefits and savings, with laparoscopic repair of hernia averaging around $2,500.
Laparoscopic surgeries should be performed by a experienced surgeon trained in minimally invasive surgical procedures. Laparoscopic surgeons should be familiar with a variety of procedures utilizing laparoscopic technique and equipment in his or her field of study or specialty. Surgeons who perform laparoscopic surgeries should be board-eligible or certified practicing surgeons, Residents or Fellows in accredited programs including gynecology, urology, and oncology, or are board eligible and certified practicing gynecologists, urologists, or other physicians who engage in and perform laparoscopic procedures.