Hiatus hernia surgery involves repairing the hernia and is usually performed when medication fails to relieve symptoms like heartburn and acid reflux, or when complications like inflammation or narrowing of the esophagus occur. The surgery aims to reposition the stomach and esophagus below the diaphragm and tighten the opening in the diaphragm. Laparoscopic surgery, using small incisions and a camera, is a common approach.

Types of Surgery

• Laparoscopic Repair :
  This minimally invasive procedure involves making several small incisions in the abdomen to insert a camera and surgical instruments. The surgeon views the surgical site on a monitor and repairs the hernia using the instruments.
• Thoracotomy :
  In some cases, surgery may be performed through a single incision in the chest wall.

Surgical Procedures

• Pulling the stomach down : The stomach and other affected tissues are pulled back down into the abdomen.
• Tightening the opening : The opening in the diaphragm is made smaller to prevent the stomach from protruding again.
• Reconstructing the esophageal sphincter : The muscles at the lower end of the esophagus may be reshaped to prevent stomach acid from flowing back up.

When is surgery needed?

• When medications don't provide adequate relief from symptoms like heartburn and acid reflux.
• When complications like inflammation, ulcers, or narrowing of the esophagus develop.
• When the hernia is large and causing significant problems, or when strangulation (blood supply cut off) is a risk.

Recovery

• Diet : Patients typically start with clear liquids and progress to soft or liquefied foods, gradually returning to a normal diet.
• Activity : Heavy lifting and strenuous activities may be restricted for a few weeks.
• Pain management : Pain medication may be prescribed to manage discomfort.
• Follow-up : Regular follow-up appointments with the surgeon are important to monitor healing and address any concerns.

Potential complications

• While surgery is generally successful, potential complications include infection, bleeding, and recurrence of the hernia.
• Some patients may experience temporary difficulty swallowing or other digestive issues.