Upper GI Hernia: Reasons and surgical option

 

Upper GI hernia

An upper GI hernia typically refers to a hiatal hernia. It occurs when a part of the stomach pushes up into the chest through the diaphragm. This can cause symptoms like heartburn, acid reflux, chest pain, and difficulty swallowing. If you suspect you have a hiatal hernia or are experiencing symptoms, it's essential to consult a healthcare professional for evaluation and appropriate management. They can recommend lifestyle changes, medications, or in severe cases, surgical options. However, there are many reasons behind the development of Upper GI hernias.

How Upper GI Hernia Develops

A hiatal hernia or upper GI Hernia develops when body tissue or an organ pushes through the dome-shaped diaphragm or a membrane which is a strong layer between the two cavities that keeps the organs of the abdomen in place, separating them from the heart and lungs in the chest cavity and it moves up and down to support breathing.

The diaphragm has a smooth surface without any open holes, but key structures and vessels run through it. The largest of these structures is the food pipe, which is essential for pushing food down for digestion.

Above the stomach, the diaphragm usually surrounds the food pipe tightly to maintain the abdominal organs and tissues in place. This narrowing of the food pipe helps to stave off the contents of the stomach from moving back up into the chest section of the food pipe. When part of the upper stomach pushes through the diaphragm at this point, an Upper GI hernia occurs.

Exploring Surgical Options for Hiatal Hernia Repair:

Hiatal hernias that cause significant symptoms or complications may require surgical intervention. Here, we'll delve into the different surgical options available for hiatal hernia repair:

Laparoscopic Nissen Fundoplication: This minimally invasive procedure is the most common surgical approach. It involves making small incisions in the abdomen to insert a laparoscope and surgical instruments. The surgeon wraps the upper part of the stomach around the lower oesophagus, reinforcing the weakened diaphragm and restoring the normal anatomy. This helps prevent stomach acid from flowing back into the oesophagus, alleviating reflux symptoms.

Laparoscopic Toupet Fundoplication: Similar to the Nissen fundoplication, this procedure also wraps part of the stomach around the oesophagus. However, it creates a partial wrap, allowing for better preservation of the ability to belch and reducing the risk of post-surgery gas-related issues.

Laparoscopic Dor Fundoplication: This surgery repairs the hiatal hernia by folding and suturing the stomach to the oesophagus without completely wrapping it. It is a less common option and is typically performed for large hiatal hernias or when Nissen or Toupet fundoplication might not be suitable.

Robotic-assisted Surgery: Some surgeons may use robotic-assisted technology to perform laparoscopic hiatal hernia repair. The robotic system allows for enhanced precision and maneuverability, potentially leading to better surgical outcomes.

Open Surgery: While less common nowadays, open surgery involves making a larger incision in the abdomen or chest to access and repair the hernia. This approach might be necessary for complex or revision cases.

Factors such as the size of the hernia, overall health, and individual preferences will play a role in determining the most suitable approach. Each procedure has its benefits and potential risks, which the surgeon will explain to the patient. Patients must discuss these surgical options thoroughly with their healthcare provider.

After the surgery, patients may experience some discomfort and will need to follow specific dietary and lifestyle recommendations during the recovery period. It's essential to adhere to post-operative instructions to ensure a smooth recovery and successful long-term outcomes.

In conclusion, surgical options for Upper GI hernias repair have come a long way, offering effective and less invasive solutions for patients experiencing significant symptoms or complications related to their condition. Always consult with a qualified surgeon to determine the most appropriate treatment plan for your specific case.

Author's bio: The author of this article is a medical health professional who successfully performed many surgeries with the help of robotics technology that assures quick healing, fewer complications, such as surgical site infection, less pain and blood loss, and shorter hospital stay and less noticeable scars.

Location: Malaysia

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