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Hiatal Hernia Plus Revision
Hiatal Hernia Repair Combined with Bariatric Surgery. Is it Possible?
Combining hiatal hernia repair with bariatric surgery is possible. However, it demands thoughtful evaluation by a skilled surgeon because of the complexity involved in treating both conditions. Here’s an overview of how the two might be managed together:
What is a Hiatal Hernia?
A hiatal hernia occurs when the upper part of your stomach pushes up through the diaphragm (the muscle that separates your chest from your abdomen) into your chest cavity. Normally, your stomach sits below the diaphragm. The esophagus (food pipe) passes through a small opening called the hiatus to connect to the stomach. In a hiatal hernia, part of the stomach bulges through this opening. This can cause symptoms like acid reflux, heartburn, or difficulty swallowing.
What is Bariatric Surgery?
Bariatric surgery refers to various procedures aimed at helping people with obesity lose weight. Common types of bariatric surgery include gastric bypass, sleeve gastrectomy, and adjustable gastric banding. These procedures alter the digestive system to limit food intake or absorption, helping with weight loss.
Combining Hiatal Hernia Repair with Bariatric Surgery
In some cases, individuals who need bariatric surgery may also have a hiatal hernia. If the hernia is causing significant symptoms (such as GERD, heartburn, or swallowing difficulties), it may need to be repaired during the same surgery. Here’s how this typically works:
- Preoperative Evaluation: Before deciding whether to perform both surgeries at once, the surgeon will evaluate the severity of the hiatal hernia and the individual’s overall health. For very large hiatal hernias, it may only be possible to complete a bariatric surgery if the hiatal hernia is addressed. A comprehensive assessment will determine if both procedures can be safely performed together.
- Surgical Approach: In many cases, bariatric surgery (like gastric bypass or sleeve gastrectomy) can be performed laparoscopically (minimally invasive). If a hiatal hernia is also present, the surgeon may repair the hernia at the same time. This is often done by suturing the opening in the diaphragm to prevent the stomach from protruding through it.
- Benefits of Combined Surgery:
- Improved Outcomes: Combining the two surgeries may improve patient outcomes. This is particularly beneficial when a hiatal hernia causes symptoms like reflux or difficulty swallowing that could hinder weight loss after bariatric surgery.
- Single Recovery Period: Patients typically benefit from a single recovery period instead of two separate surgeries, reducing time under anesthesia and overall hospital stays.
- Postoperative Long-Term Management: After surgery, patients need to follow specific guidelines for diet, exercise, and medications. This helps support weight loss and prevent complications related to the hernia repair.
