Hiatal hernia surgery

A hiatal hernia occurs when part of the stomach moves up through the diaphragm into the chest. This condition can contribute to gastroesophageal reflux disease (GERD), a condition where stomach acid flows back into the esophagus, causing symptoms such as heartburn, regurgitation, and chest pain. Surgical intervention is indicated for patients with severe GERD that does not respond to medical treatments, those with complications such as erosive esophagitis, or in the presence of a large hiatal hernia causing significant symptoms.

Before considering surgery, it is essential to perform preoperative tests to evaluate the patient's condition. One of the most important tests is the upper gastrointestinal endoscopy, which allows direct visualization of the esophagus and stomach to detect inflammation, ulcers, or other abnormalities. Additionally, esophageal pH monitoring and esophageal manometry can be performed to measure acidity and esophageal motor function, respectively.

The Nissen fundoplication is a surgical procedure in which the top part of the stomach is wrapped completely around the lower esophagus to strengthen the esophageal sphincter and prevent reflux. The Toupet fundoplication, on the other hand, is a variant where the stomach is partially wrapped around the esophagus, creating a less restrictive reinforcement. Evaluation by a specialized surgeon is crucial before deciding on the type of intervention, as it allows tailoring the treatment to the specific needs of each patient, ensuring the best possible outcomes.