Your doctor has recommended that you undergo surgery to repair a hiatal hernia. But what
does that actually mean?
Your diaphragm is a muscle that separates your chest from you abdomen and helps you
to breathe. Normally, the diaphragm has an opening for the esophagus to pass through
where it connects with the stomach.
A hiatal hernia occurs when part of the stomach pushes upward through this small opening.
Patient Education Company Your hiatal hernia may be causing considerable
discomfort, with symptoms like heartburn, difficulty swallowing, chest pain and belching.
The reasons why hiatal hernias form are not known, but they are quite common. A Hernia
is dangerous only if it becomes strangulated. That means that the portion of the stomach
that has pushed up into the chest may become pinched - preventing blood from reaching it.
If this happens, you may require emergency surgery to restore blood flow and to repair
hernia.
Your Procedure:
On
the day
of your operation, you will be asked to put on a surgical gown. You may receive a sedative
by mouth and an intravenous line may be put in.
You will then be transferred to the operating table.
The anesthesiologist will begin to administer anesthesia - most probably general anesthesia.
The surgeon will then apply antiseptic solution to the skin around the area where the incisions
will be made, place a sterile drape around the operative site.
After allowing a few minutes for the anesthetic to take effect a small incision is made above
the umbilicus; Then, a hollow needle will be inserted through the abdominal wall.
And the abdomen will be inflated with carbon dioxide.
An umbilical port is created for the laparoscope.
Four more incisions will be made, with care taken to keep the openings as small as possible.
Once in place, the laparoscope will provide video images, so the surgeon can insert the
instruments used to locate and pull back the liver...
in order to see the upper part of the stomach.
First, the surgeon pulls the stomach away from the hiatus, or opening, in the diaphragm.
Then, the surgeon cuts away the tissue that connects the liver and the stomach.
The surgeon can then dissect part of the diaphragm around the esophagus. This gives better access
to the diaphragm and the esophagus.
Next, the surgeon pulls the esophagus upwards and closes the hiatus with sutures.
Some hiatal hernias can cause persistent and painful acid reflux and your doctor may decide
to correct the problem surgically. In this case, the surgeon divides and separate the
arteries that supply blood to the top of the stomach.
After freeing the stomach from the spleen,
your doctor wraps the upper portion of the stomach around the esophagus and sutures it
into place.
A rubber tube is placed in the esophagus to keep the wrap from becoming too tight.
All of the instruments are withdrawn the carbon dioxide is allowed to escape the muscle layers
and other tissues are sewn together and the skin is closed with sutures or staples.
Finally, sterile dressings
are applied.