Hiatal hernia surgery

Hiatal hernia surgery is indicated when medications (like anti-reflux tablets) and lifestyle measures do not fully control symptoms adequately. It may also indicate when patients with hiatal hernias suffer from obstructive symptoms of food intolerance (regurgitation, dysphagia), gastric Cameron ulcers or atypical retro-sternal chest discomfort.

Hiatal hernia repair along with fundoplication (gastric wrap) has been shown to be very effective in controlling the symptoms of reflux. The aim of the surgery is to repair any existing hiatal hernias and use the wrap to create a ‘pressure zone’ in augmenting the previously defect gastro-oesophageal valve. The surgery allows patients to be relieved of their symptoms and come off regular anti-reflux medication.

It is an operation that is performed laparoscopically (keyhole) with 4-5 small incisions (0.5-1cm). The procedure is generally well tolerated with reasonably fast recovery times.

Post surgery recovery and diet

Hospital length of stay may vary between 1-3 days with 2-3 weeks off work.

The post surgery diet usually comprises of three phases:

• Fluid phase – you will be started on liquid diet while in hospital
• Mashed phase – You will be commenced on a mashed/ puree diet prior to discharge and in the first 1-2 weeks post discharge. All foods should be put through a blender and care should be taken to eat the meal portions slowly (ideally with a tea spoon)
• Normal diet – You will be commenced on a normal diet once you have been comfortable with mashed diet over the initial 2 week period. It is important to still eat sensibly, chew through food well and minimize carbonated beverages.

Complications/ side effects that can occur with surgery

Hiatal hernia surgery is a safe operation in expert hands. Never-the-less, like all surgeries, complications can occur. You should be familiarized with them before proceeding with surgery.

• General surgical related complications (bleeding, infection, pneumonia, blood clots)
• Hiatal hernia specific complications that may occur:
  • Delayed stomach emptying from vagus nerve injury
  • Inability to burp, belch, bloating or increased flatus/ wind
  • Hernia recurrence (can occur up to 10% in 10 years)