General Surgery/Hernia

Hernia Surgery in Pune

Haitus is the small opening in the horizontal diaphragm separating the stomach and the esophageal tube and chest. The esophagus passes through this opening and connects to the stomach at the lower esophageal sphincter (LES). A hiatus hernia or hiatal hernia, as the name suggests, occurs when the upper part of the stomach bulges out of this hiatus into the upper chest region.

Hiatal Hernia
Treatment
It typically occurs in two types :
1. Sliding hiatus hernia :

 When the LES muscles and the upper part of the stomach protrude up from the hiatus into the chest cavity

2. Rolling hiatus hernia :

When the fundus part of the stomach bulges up into the chest through a weak spot in the diaphragm.

Symptoms :
  • Repetitive heartburn caused due to GERD
  • Painful burning sensation in the chest and throat
  • Painful burning sensation in the chest and throat
  • Acid reflux when lying down
  • Loss of appetite
  • Feeling as if food gets stuck in the esophagus after swallowing
  • Esophageal pain when drinking hot fluid
  • Shortness of breath
  • Blood vomiting
  • Black stools
Causes :
  • Weakening of the diaphragm after a certain age
  • A congenitally weak diaphragm
  • A congenitally large hiatus opening
  • A surgical or accidental injury to the diaphragm that has left a weak spot
  • Excessively coughing, vomiting, straining during bowel movements, which strains the diaphragm
  • Heavy weight lifting or abdominal exercises
Diagnosis:

X-Ray : to check for gastroesophageal shape changes or protrusions through the hiatus or the diaphragm 

Upper Endoscopy : to visually examine the presence of a herniated part by passing an endoscope through the throat

Esophageal Manometry : the rhythmic muscle contractions and force exerted by the muscles in your esophagus

Treatment

The symptoms of mild hiatus hernia can be managed through medicinal treatments without surgery. But if the hernia grows significantly into the chest part, our gastroenterologist and hernia specialist may suggest a hernia repair surgery. During this laparoscopic surgery, also known as fundoplication,  the fundus of the stomach is wrapped and sutured around the LES part to prevent acid reflux. An open hernia surgery may also be suggested to manually reposition the herniated part and reinforce the hiatus opening with surgical meshes.

FAQ's

  • Essentially, and factor and activity that consistently puts high pressure on our muscle wall and weakens the body’s cavity can cause a hernia. The most prominent of these causes include:

    • Being overweight
    • Lifting heavyweights
    • Constant coughing
    • Congenital muscle weakness
    • Straining while passing stool
    • Smoking Excessively 
    • Old age and a family history of hernias

    Generally, people above the age of 70 and those with multiple family members with hernia issues have a much higher risk of developing it even with apt precautions.

No, hernias do not pull back inside the abdomen on their own, and even if they appear to be subsiding, the weak spot in the muscle wall remains a problem. Hence, surgically repositioning the protruded part and reinforcing the muscle wall is the only effective option for treating hernias. However, if your hernia doesn’t cause any significant discomfort in your routine life, and it remains benign, you can discuss your possibility of delaying the surgery with your hernia specialist.

It is a common cause of hernia where a part of the intestines protrudes through the muscle wall at the inguinal canal, which interiorly connects the abdominal tubes to the genitalia. These hernias are seen around the groin region and the lower abdomen and cause significant pain while exercising or passing stools. The herniated bulge may move towards the scrotum and strangulate many critical blood veins, so having an inguinal hernia surgery is extremely vital.

Hernia surgery aims to reposition the protruded part inside the abdominal wall and strength the weaker spots on the muscle wall to prevent recurrence or reappearance of a hernia. Depending on the size and condition of the herniated part, the surgeon may choose to either push it back into the abdomen or incise it and patch the healthy tissues. Finally, the surgeon uses a biocompatible patch or mesh, either absorbable or non-absorbable by the body, to shut and reinforce the hole and surrounding muscle tissues.

Unlike the open surgery method, which requires a large incision to be made, Laparoscopic surgery uses miniaturized equipment passed through key-hole size incisions around the affected area. This surgical approach has two main advantages; it significantly reduces the damage caused to the adjacent healthy tissues and the time required for the wound to heal. However, this surgery cannot be helpful in cases of relatively large hernial protrusions.

After your hernia repair, you will feel some amount of soreness for the first 24 to 48 hours, but you can sit up and carefully walk from the next day itself. Depending on the type of hernia surgery you had, your recovery period will vary drastically. Your surgeon will guide you with the right time to restart your routine activities such as showering, driving, climbing, lifting, working, etc. You’ll have to attend a periodic follow-up plan prescribed by your surgeon to track your recovery process and gradually restart your routine life.