Hiatal hernia repair options include laparoscopic, robotic surgery | TribLIVE.com
Health

Hiatal hernia repair options include laparoscopic, robotic surgery

1906473_web1_gtr-hth-hiatal-111919
Pixabay
Hiatal hernia repair surgery most often is performed as a minimally invasive procedure, either laparoscopically or robotically.

Dear Mayo Clinic: After a recent CT scan, endoscopy and colonoscopy, I learned that I have a hiatal hernia containing both stomach and colon and extrinsic stenosis at the splenic flexure. My understanding is that this is rare and that I will need surgery. Will I need to find a surgeon who has seen this condition before? Can surgery be done laparoscopically?

Answer: Given the complexity of your situation, it would be a good idea for you to find a surgeon with experience in stomach and esophageal surgery who is familiar with repairing large hiatal hernias. Surgery for hiatal hernias often can be performed using a minimally invasive approach, even for a larger hernia such as yours.

A hiatal hernia is a common problem in which the upper part of the stomach bulges, or herniates, through an opening in the diaphragm into the chest.

As is the case for you, large hiatal hernias can involve other abdominal organs, such as the colon, that then migrate into the chest along with the stomach.

The fact that you have “extrinsic stenosis at the splenic flexure” means that the hernia may be causing some pressure on the left side of your colon, called the splenic flexure. That could result in changes in your bowel habits.

Hiatal hernias may not cause any symptoms, and people often don’t know that they have them. However, symptoms from a hiatal hernia can include acid reflux, heartburn, chest pain or shortness of breath after eating a meal and difficulty swallowing, with the sensation of food getting stuck in the chest.

When other organs are involved in the hernia, such as the colon or small intestine, that may trigger abdominal pain or changes in bowel habits. Rarely, large hiatal hernias can lead to twisting of the stomach — a condition that requires emergency care.

Other options

Hiatal hernias that don’t cause symptoms may not require surgical repair and instead can be closely monitored over time. If a hiatal hernia causes mild acid reflux, medication may be used to manage those symptoms.

For larger hernias and those resulting in significant symptoms, surgery usually is necessary to properly reposition the organs and narrow the opening in the diaphragm to minimize the chance of the hernia recurring. The surgery most often is performed as a minimally invasive procedure.

To determine the best treatment approach for you, your care team may recommend additional tests before moving forward with surgery. You also should have a conversation with your surgeon to discuss the risks and benefits of hiatal hernia repair, and determine which approach is most appropriate for your circumstances.

Categories: News | Health Now
TribLIVE commenting policy

You are solely responsible for your comments and by using TribLive.com you agree to our Terms of Service.

We moderate comments. Our goal is to provide substantive commentary for a general readership. By screening submissions, we provide a space where readers can share intelligent and informed commentary that enhances the quality of our news and information.

While most comments will be posted if they are on-topic and not abusive, moderating decisions are subjective. We will make them as carefully and consistently as we can. Because of the volume of reader comments, we cannot review individual moderation decisions with readers.

We value thoughtful comments representing a range of views that make their point quickly and politely. We make an effort to protect discussions from repeated comments either by the same reader or different readers

We follow the same standards for taste as the daily newspaper. A few things we won't tolerate: personal attacks, obscenity, vulgarity, profanity (including expletives and letters followed by dashes), commercial promotion, impersonations, incoherence, proselytizing and SHOUTING. Don't include URLs to Web sites.

We do not edit comments. They are either approved or deleted. We reserve the right to edit a comment that is quoted or excerpted in an article. In this case, we may fix spelling and punctuation.

We welcome strong opinions and criticism of our work, but we don't want comments to become bogged down with discussions of our policies and we will moderate accordingly.

We appreciate it when readers and people quoted in articles or blog posts point out errors of fact or emphasis and will investigate all assertions. But these suggestions should be sent via e-mail. To avoid distracting other readers, we won't publish comments that suggest a correction. Instead, corrections will be made in a blog post or in an article.