The oesophagus carries food from the mouth to the stomach. It passes through the muscle between the abdomen and chest (diaphragm) just before it meets the stomach, through an opening called the oesophageal hiatus. When the opening in the diaphragm is too large, some of the stomach can slip up into the chest cavity. This can cause heartburn (gastro-oesophageal reflux: GORD) due to gastric acid backflowing from the stomach into the oesophagus. Hiatal hernia repair is by bring the stomach back down into the abdominal cavity and tighten the diaphragm muscle around the bottom of the oesophagus. The ‘valve’ at the bottom end of the oesophagus is re-created by wrapping the top part of the stomach ‘fundus’ over it. This is called a fundoplication.
This surgery can be performed very safely in a ‘minimally invasive/keyhole’ way. In rare circumstances open surgery may be required, particularly if there has been previous surgery in the area.
Hiatal hernia repair may be recommended when the patient has:
Using keyhole surgery the stomach and lower oesophagus are placed back into the abdominal cavity. The opening in the diaphragm (hiatus) is tightened and the stomach is stitched in position to prevent reflux. The upper part of the stomach (fundus) may be wrapped around the oesophagus (fundoplication) to reduce reflux.
Patients may need to spend 3 to 10 days in the hospital after surgery. Rarely, a tube may need to be placed into the stomach through the nose and throat (nasogastric tube) during surgery and may remain for a few days. Small, frequent meals are recommended.
1. Recurrence of the hernia up to 15-20%
2. Difficulty swallowing for 6 weeks occasionally requiring further treatment with stretching of oesophagus
3. Difficulty vomiting or belching with occasional increase in flatulence, all of which are mostly temporary
4. Rarely, injury to the internal organs
There is no waiting list. If you wish, your operation can usually be performed within a week or two or planned at a time of your choosing. For most patients with full private health insurance there will be some extra costs not covered by Medicare or your health fund. The cover provided by your health fund will vary according to which fund and which level of cover you have and in some cases you may have to pay an “excess”. It is your responsibility to check with your health fund prior to surgery. Full financial details will be provided to you prior to surgery. Occasionally other tests, procedures or specialist consultations may be necessary and some other costs incurred.
Hospitals used by LapSurgery Australia for this surgery are:
If you do not have private health insurance, you can expect to have a higher out of pocket depending on where you have your surgery. Following your consultation with our surgeon our staff will be able to give you an informed financial consent prior to going ahead with surgery.
Public hospital waiting lists are very long and the surgery is usually carried out by trainee surgeons under the supervision of one of the specialist surgeons appointed by the hospital. There is no choice of surgeon in the Public Hospital and your LapSurgery Australia surgeon cannot not be involved in your operation.