Laparoscopic hiatus hernia repair and fundoplication

Description

Laparoscopic hiatus hernia repair with fundoplication involves dissecting the junction between the swallowing pipe and the stomach, as it enters the abdomen. Any associated hiatus hernia (abnormal protrusion of the top of the stomach into the chest) is repaired. The upper part of the stomach (‘fundus’, hence ‘fundoplication’) is then partially wrapped around the lower part of the swallowing pipe (‘oesophagus’) in the abdomen. This recreates the natural valve that stops acid reflux.

Indications

Side effects

Severe GORD/Gastro-Oesophageal Reflux Disease:

  • Symptoms poorly controlled by medication, including sleep disruption.
  • Pre-cancerous change in the oesophagus, ie complex/high risk Barrett’s oesophagus.
  • Laryngo-pulmonary reflux causing cough and lung disease.

The hiatus hernia repair and fundoplication is deliberately performed loosely. The vast majority of patients experience resolution or dramatic improvement in their reflux symptoms and quality of life. Difficulty swallowing solids and bloating side effects are rare over the longer term. Like all hernia repair surgery, there is a risk of recurrence long term. This is particularly relevant for giant hiatus hernia repair cases.

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