Esophagus passes through anopening in the diaphragm (i.e. hiatus) on its way to connect to the stomach.Hiatal hernias occur when the muscle tissue surrounding hiatus becomes weak,causing the bulging of the upper part of the stomach through the diaphragm intothe chest cavity. It is generally caused due to obesity, pregnancy, aging, orthinning of the phrenoesophageal membrane.
Symptoms of Hiatal Hernia
A small hiatal herniagenerally does not cause any symptom and need no treatment. But an enlargedhernia can cause following symptoms:
? Heartburn - 30 - 60minutes after eating
? Regurgitation of stomachcontents that gets worsened with lying flat
? Excessive belching
? Aspiration (reflux ofstomach contents into the airway)
? Recurrent Asthmaattack’s
? Pain or burning in chest
? Difficult or painfulswallowing
? Vomiting blood or passingblack stools
Diagnosisof Hiatal Hernia
It is often diagnosed whilediagnosing the reason of heartburn or chest or upper abdominal pain byperforming following evaluations:
? Physical examination
? Esophagram (bariumswallow)
? Upper endoscopy
? Esophageal manometry
? pH metry & Impedence( if required)
LaparoscopicCruroplasty and Nissen fundoplication for Hiatal Hernia
Laparoscopic Cruroplastyand Nissen fundoplication is the procedure of choice for repair of asymptomatic as well as asymptomatic hiatal hernia.The laparoscopic Cruroplastyand Nissen fundoplication is performed through five quarter-inch incisions.Laparoscope and other instruments are inserted through these incisions. Thehernia is reduced from the chest into the abdomen. This may require separationof abdominal organs from the lung and middle chest structures. This is followedby repair of hiatus to its appropriate size and construction of a new loweresophageal valve. Prosthetic material is used in cases of large hernias withpoor tissue to prevent recurrence. The procedure takes about two to four hoursdepending on the size and contents of the hernia.
Advantagesof Laparoscopic Cruroplasty and Nissen fundoplication for Hiatal Hernia Repair
? Faster recovery
? overnight hospitalization
? Sooner return to work
? Very less pain during andafter the procedure
? Smaller incisions withoutany cut on abdominal muscles
? Negligible risks andcomplications
? Less chances of woundinfection
? High success rate withmore than ninety-percent of symptom free patients after ten years of theprocedure.
Dr. Rahul Mahadar Best Laparoscopic Surgeon for Hiatal Hernia Surgeryat Jeevanshree Hospital  Dombivli , Kalyan , Diva , Ambernath , Badlapur ,Ulhasnagar.
call for appointments:9920027124