Laparoscopic Reflux/Hiatal Hernia Repair in Baltimore, Maryland

Gastroesophageal reflux disease is a widespread condition presenting with heartburn, regurgitation, hoarseness, and pain or difficulty with swallowing food. It is a result of dysfunction of the normal valve mechanism at the junction of the esophagus and stomach. It is often associated with hiatal hernia of variable degrees. When the stomach is displaced into the chest it can cause nausea, vomiting, pain after eating, regurgitation of food, or progressive inability to swallow food. Additionally, 10-15% of bariatric patients suffer from reflux symptoms frequently associated with hiatal hernia that was not addressed during their initial bariatric procedure, recurred, or developed after weight loss. These reflux symptoms can affect the quality of life and do not always respond to medical therapy with antacids. Depending on the clinical situation, the reflux can be addressed with a few different procedures.

Gastroesophageal reflux disease (GERD)
Hiatal Hernia

Fundoplication

The most common surgery designed to repair the valve mechanism is called a Fundoplication and is combined with a hiatal hernia repair.  This procedure consists of reduction of the herniated junction of the esophagus and stomach into the abdomen with the closure of diaphragm muscle defect to keep the stomach in the abdomen.  The top of the stomach is then wrapped around the esophagus to recreate the valve. We perform a partial or toupet fundoplication which has fewer significant side effects compared to the more widely known complete Nissen fundoplication.

Fundoplication

A fundoplication may be an option for you if:
  • You have significant reflux that is not responsive to medication therapy
  • Have a large hiatal hernia
  • Have a desire to stop taking your antireflux medication

Advantages

  • Low mortality rate
  • Ability to address large hiatal hernia at the same time
  • High rates of reflux remission
  • Procedure has a long history with well established clinical outcomes
  • Three different degrees of wrap, so can be personalized to your particular situation

Disadvantages

  • Not able to be performed on patients who have had a sleeve gastrectomy or duodenal switch
  • Difficult to perform on patients who have undergone a roux en y gastric bypass
  • Possibility of recurrence
  • Higher rates of gas bloat, dysphagia and flatulence
  • Foods that you eat now may cause discomfort, nausea or vomiting after your surgery
  • Requires adherence to dietary recommendations and follow-up compliance
  • Patients with high BMI may need an additional procedure to prevent recurrence
How long does hiatal hernia repair last?
Ideally, hiatal hernia repair will last a lifetime. However, hiatal hernia recurrences do happen, and are generally repaired in the same way the surgery was done initially. In case of recurrence, patients are asked to report it immediately.

 

How much does hiatal hernia surgery cost?
In order to get an accurate estimate of the cost of hiatal hernia surgery, you’ll need to contact us. We’ll give you an accurate cost estimate, including all relevant fees, and we’ll help you figure out what your insurance will be able to pay.

 

Can a hiatal hernia come back after surgery?
Hiatal hernia recurrences do happen and, depending on the way the procedure was done, can be common. However, hiatal hernia recurrence typically isn’t much of a worry and can be repaired in a similar way the surgery was initially done.

 

What is the success rate of hiatal hernia surgery?

Hiatal hernia surgery success rate, on average, is between 90 and 95 percent. This rate does not include recurrences that happen years after surgery. Many factors impact the success rate of hiatal hernia surgery. We ask that if you have any concerns, schedule a consultation with us.

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