Paraesophageal and Giant Hiatal Hernias treatment
When dealing with complex hernia conditions such as paraoesophagal and giant hiatal hernias, it is essential to seek care from an experienced and highly skilled surgeon. Dr Sherif Awad, a renowned expert in laparoscopic surgery for giant hiatus hernias, offers advanced treatment options, including keyhole surgical repair for giant hiatus hernias, to ensure the best outcomes for his patients.
Understanding paraesophageal and giant hiatal hernias
Large or giant hiatal hernias occur when a significant portion of the stomach (over 50%) slips up into the chest cavity through the diaphragm. This can lead to various complications, including acid reflux/heartburn, vomiting after eating, chest pain on eating, difficulty swallowing or food sticking and inadvertent weight loss.
Paraesophageal hernias, a type of large hiatal hernia, occur when the stomach pushes up beside the oesophagus. These hernias can be particularly dangerous as they may twist and obstruct the stomach, leading to severe complications such as loss of blood supply to the stomach or even emergency situations requiring urgent surgery.
Symptoms and diagnosis
Patients with paraesophageal or giant hiatal hernias may experience a range of symptoms, including:
- Chest Pain: This is a common symptom, especially after eating. Patients often describe it as a sharp, persistent pain that may mimic pain from the heart.
- Epigastric Pain: Pain located in the upper middle part of the abdomen, often exacerbated by meals.
- Dysphagia: Difficulty swallowing, or food sticking, often due to the oesophagus being compressed or displaced by the hernia.
- Shortness of Breath: In very large hernias, the stomach may push against the diaphragm or lungs, leading to breathing difficulties.
- Early Satiety and Bloating: Due to the stomach’s compromised position, patients may feel full quickly or experience prolonged bloating.
- Chronic Blood Loss and Anaemia: In some cases, patients may develop a specific type of stomach ulcer known as Cameron’s ulcer, leading to slow, chronic blood loss and subsequent anaemia.
To diagnose this condition patients will often need an endoscopy. This involves inserting a thin camera down the throat to visualise the oesophagus, stomach and diaphragm opening. Additional diagnostic tests may include a barium swallow X-ray or CT scan of the chest and tummy, Occasionally there is a need to perform oesophagal pH and manometry studies to assess the oesophagus’ function and amount of acid reflux.
When is surgery necessary?
Not all hiatal hernias require surgery, but giant hiatal hernia surgery is typically recommended for patients experiencing severe symptoms or those at risk of serious complications. Surgery is particularly crucial when the hernia causes significant discomfort, impairs daily activities, or threatens the stomach’s blood supply.
Surgical treatment options
Laparoscopic (keyhole) surgery for giant hiatus hernia is the preferred method for repairing paraesophageal and giant hiatal hernias. This minimally invasive technique involves making five small incisions on the tummy under general anaesthesia.
The surgical procedure
During laparoscopic surgery for a paraesophageal or giant hiatal hernia, the surgeon carefully moves the stomach back into the abdominal cavity. The opening in the diaphragm (oesophageal hiatus) is then tightened with sutures (with or without use of a mesh as appropriate) to reduce the risk of future herniation.
For many patients, the procedure also includes a partial fundoplication wrap, where the top of the stomach is stitched to the hiatus to reduce acid reflux and risk of hernia recurrence.
Recovery and outcomes
Patients undergoing laparoscopic surgery for paraoesophageal or giant hiatal hernias typically benefit from shorter hospital stays and faster recovery compared to traditional open surgery. Most patients are discharged within one day and can return to normal activities within two weeks.
The results of keyhole surgery for hernia repair are generally excellent, especially when performed by a surgeon with extensive experience in laparoscopic techniques like Dr Sherif Awad. While some patients may experience temporary side effects such as bloating or difficulty swallowing, these symptoms usually improve over time.
Why choose Dr Sherif Awad?
As a leading specialist in laparoscopic surgery for giant hiatus hernia, Dr Sherif Awad brings unparalleled expertise to the treatment of complex hernias. His dedication to patient care, combined with advanced surgical techniques, ensures that each patient receives the best possible outcome. Whether you are dealing with a giant hiatal hernia or a paraesophageal hernia, Dr Sherif’s approach focuses on minimising risks, reducing recovery time, and restoring your quality of life.
Schedule a Consultation
If you are experiencing symptoms related to a paraesophageal or giant hiatal hernia, it is essential to seek expert medical advice. Dr Sherif Awad is here to guide you through your treatment options and help you determine if laparoscopic surgery is right for you. Contact Dr Sherif’s office to schedule a consultation.
