A hiatal hernia occurs when there is an enlarged or weakened section of the hiatus, the opening in the diaphragm through which the esophagus passes. This type of weakness of the diaphragm can allow a small portion of the stomach to protrude into the chest cavity, causing or exacerbating Gastro Esophageal Reflux Disease (GERD). Many patients benefit from a surgical repair of the hiatal hernia (often with synthetic materials - a "mesh").. In addition to repairing the hernia, Dr. Bhoyrul and his team at Olde Del Mar surgcial, wrap part of the stomach around the lower part of the esophagus to create a valve that prevents acid reflux. Dr. Bhoyrul has performed hundreds of these operations, not only for patients who suffer from GERD, but also for patients who have Paraesophageal hernias. A paraesophageal hernia is a more serious type of hiatal hernia which poses a risk of strangulation of the stomach if the hernia is not fixed surgically. Patients with paraesophageal hernias are often older and sometimes less healthy than most patients with a typical hiatal hernia. Dr. Bhoyrul also has experience in laparoscopically revising hiatal hernia surgeries that have come undone or may not have been correctly performed.
Some patients who have hiatal hernia surgery can experience difficulty swallowing or feeling bloated for the first 3 months after surgery. Most of the time these symptoms do not persist, and the likelihood of successful repair of the hiatal hernia approaches 95%.
For patients who suffer from severe obesity, in addition to a hiatal hernia, it is sometimes preferable to combine the hiatal hernia repair with weight loss surgery. Dr. Bhoyrul and his team will be happy to discuss whether or not this might be a preferred approach in your case. Obesity is a risk factor for many health conditions, and also for the failure of hiatal hernia surgery, so that combining hiatal hernia surgery with a strategy for weight management is ideal. Often this simply entails a consultation with our dietitian to help our patients make smarter food choices.