Paraesophageal hernia repair

Indications

Usually for symptoms caused by compression of the stomach by the diaphragm or twisting of the stomach. Feeling full easily, weight loss, pain after eating, vomiting, regurgitation, bleeding from the stomach, sometimes shortness of breath

Technique 

Five small incisions are made and the stomach and a hernia sac are removed from the chest and brought back to the abdomen. The diaphragm is then repaired and a fundoplication (wrapping of the stomach around the lower esophagus) is performed

Complications

Infection 1% - mesh removal may be necessary if used

Bleeding, serious <1% but can be life threatening

Injury to esophagus, stomach or nerves to the stomach 1%

Immediate failure with re-operation 1%

Difficulty swallowing after recovery 3% - can require stretching of the esophagus or revision

Gas bloat syndrome - fullness and bloating - may need medication 5%

Long term recurrence 15-20%

Reoperation long term 5%

Medical complications: heart attack, stroke, blood clots, pneumonia, etc. depending on underlying health

Recovery

1-3 days in hospital

Return to most activities within 1-3 weeks depending on pain

No lifting >10-15lbs for 6 weeks

No flying 6 weeks

Special diet - see a dietician before surgery