Hernia - Hiatal Open Repair
|Your doctor has recommended that you undergo surgery to repair a hiatal hernia. But what does that actually mean?
Your diaphragm is a muscle that separates your chest from your abdomen and helps you to breathe.
Normally, the diaphragm has an opening for the esophagus to pass through where it connects with the stomach.
A hiatal hernia occurs when part of the stomach pushes upward through this small opening.
Your hiatal hernia may be causing considerable discomfort, with symptoms like heartburn, difficulty swallowing, chest pain and belching. The reasons why hiatal hernias form are not known, but they are quite common.
A hernia is dangerous only if it becomes strangulated. That means that the portion of the stomach that is pushed up into the chest may become pinched - preventing blood from reaching it.
If this happens, you may require emergency surgery to restore blood flow and to repair the hernia.
Luckily, the vast majority of hernias are not considered to be emergencies. However, if you should ever feel a sudden onset of severe pain in your chest or stomach, you should seek medical attention immediately.
So make sure that you ask your doctor to carefully explain the reasons behind this recommendation.
After you're asleep, the surgical team will make a mid line incision, from the breastbone to the navel.
Opening this incision reveals tissues that connect the abdominal muscles.
Another incision is made through these tissues to allow access to the abdominal cavity.
Your surgeon will use a special oval ring to hold the incision open during the operation.
First, the surgeon gently lifts the liver up and away from the stomach. The surgical team can now see the place where the esophagus and stomach join.
Then, the surgeon cuts away the tissue that connects the liver and the stomach. This gives your doctor better access to the diaphragm and the esophagus.
Next, the surgeon pulls the esophagus upward and closes the hiatus with sutures.
Your doctor may insert a rubber tube in your esophagus to keep the sutures from tightening too much around your airway.
Some hiatal hernias can cause persistent and painful acid reflux and your doctor may decide to correct the problem surgically.
In this case, the surgeon divides and separates the arteries that supply blood to the top of the stomach.
After freeing the stomach from the spleen, your doctor wraps the upper portion of the stomach around the esophagus and sutures it into place.
A rubber tube is placed in the esophagus to keep the wrap from becoming too tight.
The special ring is withdrawn the tissues that join the abdominal muscles are sewn together and the skin is closed with staples.
Finally, sterile dressings are applied.
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