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Procedure Name

Open Hiatal Hernia Repair
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Surgery Type

Hernia Repair Surgery
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Hospital Stay

Typically 1 to 2 days
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Duration of Surgery

Around 1 to 2 hours
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Type of Anaesthesia

General anesthesia
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Full Recovery

Usually within a few weeks

Overview

A hiatal hernia is a medical condition that occurs when the upper part of your stomach protrudes through the diaphragm (a band of muscle that separates your abdomen and chest) into your chest. The main etiology (cause) includes increased pressure within the abdominal cavity that pushes the tissues, forming a hernia. Usually, hiatal hernias do not have any symptoms and are harmless, but sometimes they may present with symptoms like heartburn, acid reflux, and chest pain. They do not require treatment and can be managed through lifestyle changes and over-the-counter medications; however, you may require surgery if the blood supply to the protruded part of the stomach is cut off. There are different types of surgical methods, depending on the severity of the condition.

This article explores open hiatal hernia repair, its procedure, and the possible associated risk factors.

What Is Hiatal Hernia?

Your diaphragm consists of a small opening, known as the hiatus, through which your esophagus (food pipe that connects your throat and stomach) passes before it connects to your stomach. Due to increased pressure within the abdominal cavity, a part of your stomach protrudes through the hiatus into your chest, also known as a hiatus hernia. 

There are two types of hiatal hernia:

  • Sliding hiatal hernia: Your stomach and the lower part of your esophagus push (or slide) through your diaphragm into your chest.
  • Paraoesophageal or fixed hiatal hernia: This is a more serious condition when a part of your stomach pushes through your diaphragm and stays there (fixes itself).

Usually, hiatal hernias are asymptomatic, but a few symptoms may include:

  • Trouble swallowing
  • Heartburn that aggravates when you lie down
  • Gastroesophageal reflux disease (GERD)/ acid reflux 
  • Abdominal pain and bloating
  • Chest pain
  • Belching (burping)

How Is Hiatal Hernia Managed?

Most hiatal hernias are harmless; hence, they may not require any treatment. However, symptoms of GERD (acid reflux, vomiting, heartburn, regurgitation, chest pain, etc.), can be managed through:

Lifestyle changes

  • Avoid certain acidic foods (citrus foods or juices) that may irritate the inner lining of your esophagus.
  • Maintain a stable and healthy weight.
  • Decrease the portion size of your meals, and consume 5 to 6 small meals per day instead of 3 meals.
  • Limit fried and fatty foods and caffeinated and carbonated drinks.
  • Have your dinner at least 2 to 3 hours before your bedtime.
  • Raise the level of your head while lying down to keep your stomach contents in your stomach.
  • Quit smoking. 
  • Avoid wearing tight belts or clothing around your abdomen

Medications

  • These decrease the amount of acid in your stomach to prevent acid reflux.
  • You may opt for over-the-counter antacids that relieve symptoms like heartburn, acid reflux, etc.

When the above methods fail to provide relief, and if a part of your stomach enters the esophagus and is squeezed, cutting off the blood supply, an open hiatal hernia repair is recommended.

What Is Meant By An Open Hiatal Hernia Repair?

Open hiatal hernia repair is a traditional surgical approach that aims to correct gastroesophageal reflux. It works by:

  • Pushing the healthy stomach tissues back into the abdomen.
  • Placing a mesh to decrease the size of the hiatus.
  • Improving the valve mechanism at the bottom of the esophagus. 

How To Prepare For An Open Hiatal Hernia Repair?

Your surgeon will discuss with you the procedure and the pros and cons that will help prepare you physically and mentally for the hernia repair. 

  • You will be asked to undergo certain blood and imaging tests to identify bleeding disorders or complications.
  • Inform your surgeon about your medical history to rule out any pre-existing diseases like diabetes (increased blood sugar levels), hypertension (high blood pressure), etc., to take necessary precautions during and after the hernia repair.
  • To avoid complications, it is important to inform your surgeon about your medication history, drug allergies, previous surgeries, or accidents. 
  • You are advised to stop using certain medications like blood thinners, aspirin, and herbal supplements 2 weeks before the surgery.
  • Avoid alcohol 24 hours before the hernia repair since it may delay the wound healing. 
  • You must fast at least 6 to 8 hours before the surgery.
  • You are expected to sign a consent form to permit the surgery.

How Is An Open Hiatal Hernia Repair Performed?

An open hiatal hernia repair is an inpatient procedure that requires hospitalization for at least a day or two since it is an invasive procedure (and may involve trauma with a longer recovery period).

  • You are taken to the operating room and made to lie on the operating table. 
  • An intravenous (IV) line will be inserted for fluids and medications.
  • A catheter (thin tube) may be placed to help you urinate during the surgery.
  • The surgical site is thoroughly cleaned with an antiseptic solution to remove the surface contaminants.
  • You will be given general anesthesia, which will completely sedate you; hence you will not feel any pain or discomfort during the surgery.
  • Once the effect of anesthesia sets in and the area is numb, using a surgical instrument (scalpel), your surgeon makes a large incision near the area of your hiatus to gain better visibility of the site.
  • The hiatal hernia is pushed back into the abdomen.
  • Your surgeon places a prosthetic (artificial) mesh to tighten and decrease the size of the enlarged hiatus, preventing your stomach from bulging upward.
  • The incision is closed through sutures (stitches).
  • A waterproof surgical dressing is placed on the stitches to protect them from infection.
  • The entire surgery may take around 2 to 3 hours, depending on the severity of the condition. 

What To Expect After An Open Hiatal Hernia Repair?

After an open hiatal hernia repair, the following is expected:

  • You will be kept in the recovery room for an hour or two until you regain consciousness.
  • Your vitals, like blood pressure (BP), sugar levels, and pulse, will be continuously monitored.
  • You will likely have mild pain, bruising, and swelling around the operated site. This can be managed through pain relief medications.
  • You may have to stay in the hospital for a day or two, depending on the severity of your condition.
  • You are made to walk the next day to prevent the formation of any blood clots.
  • Once you return home, you can resume your normal diet; however, avoid spicy, fried, and citrus foods, alcohol, and caffeinated drinks for a few weeks.
  • You can bathe the next day but avoid soaking the surgical dressing in bathtubs to prevent infections.
  • Keep your dressing clean and dry and change it every 2 to 3 days.
  • Avoid lifting heavy objects and strenuous exercises and activities for at least 2 to 3 weeks.
  • Follow-up consultations are important to determine the success of your surgery and the recovery process. 

What Are The Risks Associated With An Open Hiatal Hernia Repair?

An open hiatal hernia repair is a safe procedure when performed by a skilled and experienced surgeon; however, there could be a few possible risks, including:

  • Internal bleeding due to incisions made near the hiatus.
  • Infections that may cause high-grade fever (>104 degrees), chills, and pus discharge from the surgical site.
  • Trauma to nearby structures and organs may delay healing and prolong recovery.
  • The presence of an unaesthetic scar may cause any skin changes like discoloration or bruising.
  • Post-operative complications like inability to swallow or continued acid reflux.
  • Allergies due to anesthesia may cause dizziness, vomiting, hives and rashes, and shortness of breath.
  • Mesh dislodgement.
  • Recurrence of the hernia in rare cases.

Why Choose Medfin?

Surgery can be a daunting aspect, and feeling anxious is absolutely normal. The massive amount of information you can get from the internet may confuse you even more. This is where Medfin can help. Leave us the hefty task of finding the best hospital, the finest doctor, and the latest procedure at the lowest cost. Let us take charge while you sit back and focus on your health and recovery. Think surgery! Think Medfin!

The power of Medfin in patient’s words

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“ Got to know about them from my friend. They got an appointment for only 299. Once the doctor confirmed that I needed the surgery they got me a fixed cost which included ALL the costs. No extra amounts were charged. Thank you Medfin”

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“ After my consultation with the doctor, MEDFIN representative got me a fixed package cost that included my mothers initial tests, surgery cost. They also gave me stockings free for Rs. 3000 post the surgery. They kept up their promise they made”

Radhika Iyer Mumbai 8 days ago
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