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Category: Hernia Surgery

Reflux and Hiatal Hernia

April 17, 2017 9:41 am

One of the leading reasons for Gastro-esophageal reflux disease (GERD) is a physical defect called a Hiatal hernia. The esophageal Hiatus is the opening in the diaphragm where the esophagus enters from chest cavity allowing the esophagus to pass into the abdominal space. If the opening in the diaphragm is much larger than the esophagus, it will result in reflux of the stomach secretions and food from the stomach into esophagus. *Note: Graphic surgical pictures below

Hiatal Hernia Causes:

  • heavy lifting
  • coughing
  • obesity
  • injury
  • persistent vomiting
  • age related

Reflux and Hernia Symptoms:

  • sour taste
  • reflux
  • heartburn
  • belching
  • chest or abdominal pain
  • difficulty swallowing
  • vomiting
  • no symptoms
Anatomical picture of Hiatal hernia with reflux
Anatomical picture of Hiatal hernia with reflux
Surgical repair of Hiatal hernia causing reflux
Surgical repair of Hiatal hernia causing reflux

The treatment includes dietary changes, medication and in those who do not improve surgery.

Hiatal hernia repair includes tightening of the dilated opening of the esophageal hiatus by re-appoximating the separated muscle fibers of the right and the left crus. This tightens the defect in the diaphragm and helps prevent part of the stomach or stomach contents from entering the chest cavity.

You can find further information and dietary changes regarding Hiatal Hernia and GERD here, including information unique to weight loss surgery and Hiatal Hernia. You can also find further surgical information, as well as a surgical video here.

BMI Threshold for Ventral Hernia Repair

July 21, 2016 2:48 pm

“After Ventral Hernia Repair (VHR), complications are most likely to occur in patients with BMI ≥ 40 kg/m2. This subset of patients also had a significantly higher risk of undergoing surgery for a recurrent hernia, suggesting that this group of patients is likely to experience adverse outcomes after VHR and should be counseled to consider bariatric surgery prior to attempts at VHR.” Information on Bariatric Surgery here.

Read more of the original article here….

A hernia is present when part of an internal organ or tissue bulges through a defect or weak area in the belly wall (fascia). The type of hernia you have depends on where it is and how it occurs. Ventral Hernias are named after the location in the body they occur. A ventral hernia is a bulging of the abdominal wall anteriorly. When the hernia is located at the site of a pervious surgical scar then it is called an incisional hernia. A hernia can occur at any location of the abdominal wall however. Further information regarding incisional hernia here.

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A Ventral Hernia can develop due to straining, lifting or increased abdominal pressure and is a weakening of the abdominal wall. Usually fat and internal organs bulge outside the facsia that holds the internal organs within the abdominal cavity. This type of hernia can be asymptomatic or cause pain with pressure or exertion. If left untreated, they can become larger or become incarcerated requiring emergent surgical intervention. Dr. Ara Keshishian performs ventral hernia repairs using a laparoscopic technique that may or may not require mesh repair. Mesh is place behind the defect in the abdomonial wall and extends past the hernia edges. Mesh is used to re-enforce the abdominal wall and allowing the healing tissue to form a sturdy foundation to help prevent reoccurrence of the hernia. Videos of Ventral Hernia Repairs here.