GERD & Hiatal Hernia Repair at Apollo Hospitals, Karnataka

The diaphragm has an opening called the oesophagal hiatus. In patients with hiatal hernia, the upper part of the stomach pushes into the chest cavity through this opening. GERD, or on the other hand, gastroesophageal reflux disease, refers to a digestive disorder in which bile or stomach acid flows back into the oesophagus, causing inflammation or irritation.

Hiatal hernia and GERD are fundamentally different medical conditions but often are related. GERD can actually be a symptom of a hiatal hernia a lot of times and require a single surgical treatment for both conditions.

Procedure of GERD & Hiatal Hernia Repair at Apollo Hospitals, Karnataka

The treatment approach for GERD and Hiatal hernia can be different for different patients. Initially, the patient may be given medications and advised lifestyle modifications to help with the symptoms. However, if the hernia is causing severe, long-lasting (chronic) oesophageal reflux whose symptoms are not relieved by medical treatments or the hernia is squeezing the oesophagus tightly to the extent that the blood supply is being cut off, then surgery will be required to perform the repair.

A surgery called Nissen fundoplication will be performed to repair & treat the hiatal hernia and GERD. The surgery may be performed laparoscopically or as open surgery, depending on the condition of the patient. Most doctors will prefer to perform the surgery laparoscopically if the patient is eligible, as it is minimally invasive and cause less trauma compared to open surgery.

Before Surgery

Before scheduling a repair surgery, the doctors will run some tests to examine the stomach and oesophagus. These tests include:

1. GI X-rays (barium swallow X-rays)
2. Oesophageal manometry
3. pH probe
4. Upper Endoscopy

Our doctors will evaluate the test results and schedule the surgery. This is a good time to ask the doctor about any queries that patients might have about the procedure. Patients are advised to arrange for someone to drive them to their surgery appointment and be with them during recovery. The patient will also be asked to fast before the surgery.

During Surgery

The procedure for GERD and Hiatal repair may differ depending on whether the surgery is open or laparoscopic. Before the surgery begins, the patient will be given general anaesthesia through an intravenous line. They may also be given a breathing tube to assist in regular breathing during the surgery.

1. Open Surgery

The surgeon will make a large incision in the abdomen and then wraps the upper part of the stomach around the lower part of the oesophagus. Once the procedure is done, the surgeon will close the incision.

2. Laparoscopic Surgery

In a laparoscopic surgical approach, the surgeon will make a few tinier incisions in the abdomen. Following that, a laparoscope will be placed into the abdomen. Through the camera and tiny operating tools attached to the laparoscope, the surgeon will wrap the upper stomach around the lower oesophagus. The incision will then be closed.

After Surgery

After the surgery, the patient is shifted to the recovery room. Patients may feel a sore throat for a few days after the surgery due to the breathing tube that was inserted during the surgery. Also, patients who go through open hiatal hernia repair will need a temporary Nasogastric (NG) tube to clear the stomach of digestive juices. Patients may also need an IV (intravenous) line to deliver fluids until they can normally eat again.

Take note of the following things regarding post-surgery time:

• Diet: The patients may be advised to have a liquid diet for a couple of days and then transition to softer foods and then regular meals.
• Hospital Stay: Patients who were operated on laparoscopically can be discharged the next day. Open-surgery patients may need to stay a couple of days before being discharged.
• Medication: Patients will be given medication to manage pain and other symptoms.
• Physical activity: Patients will need to restrict themselves from lifting anything heavy or performing any strenuous activity for a few weeks after the surgery.
• Follow-up appointment: Our doctors will schedule a follow-up appointment to monitor the patient’s recovery and evaluate the effectiveness of the surgery.
• Recovery: The recovery period may vary from patient to patient and will also depend on the type of surgery that was performed. Patients who had laparoscopic surgery will recover faster in general. Complete recovery, however, may take several weeks.

Complications & Risks

Like any surgical procedure, GERD & Hiatal Hernia Repair surgery carries some risks and potential complications, including-

• Adverse reaction to anaesthesia
• Bleeding
• Damage to internal organs or structures
• Difficulty swallowing
• Gas-bloat syndrome
• Infection
• Pneumothorax
• Recurrence of symptoms
• Tear of stitches used for the surgery

In addition to these, other common symptoms associated with surgical complications may occur in some cases. Patients must keep an eye on their symptoms and must immediately notify our healthcare providers if any new symptoms occur after the procedure.

Who is not eligible for GERD & Hiatal Hernia Repair surgery?

While GERD & Hiatal Hernia Repair surgery can be an effective treatment for GERD and hiatal hernia, not everyone is a suitable candidate for the procedure. Individuals not eligible for this surgery include those with the following conditions:

1. Inability to tolerate general anaesthesia
2. Significant oesophagal motility disorders or abnormal anatomy
3. Severe lung disease or other respiratory problems
4. History of gastric surgery or other significant abdominal surgeries.
5. Bleeding disorder or issues that require patients to take anticoagulant medication regularly.

Doctors at Apollo Hospitals, Karnataka, will run a series of tests and physical examinations and take a complete medical history of the patients before determining if they are eligible for a GERD and Hiatal hernia repair.

GERD and Hiatal hernia are conditions that can cause long-term symptoms and discomfort to the patient. Nissen fundoplication is an effective treatment for the condition. However, the procedure must only be performed by doctors who are experts in both open and laparoscopic types of the procedure.

Apollo Hospitals, Karnataka, has highly trained doctors and medical staff who help the patient at every step of their treatment, from diagnosis to recovery. The hospital is also home to technologically advanced medical equipment and state-of-the-art infrastructure that aid in increasing the success rates of the procedure performed here. Several patients get successfully treated for similar conditions and can vouch for the care and compassion offered by the highly-trained and experienced medical staff at Apollo Hospitals, Karnataka.