| HIATUS HERNIA REPAIR,
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to the right for a detailed
diagram of the procedure
LAPAROSCOPIC NISSEN FUNDOPLICATION, HIATUS HERNIA REPAIR
The procedure involves the creation of a new lower oesophageal sphincter
valve to cure gastro-oesophageal reflux disease (GORD or GERD), and the
repair of a symptomatic hiatus hernia (if present) by laparoscopic surgery.
here for a detailed diagram of the abdomen
1. Symptomatic hiatus hernia
2. Severe gastro-oesophageal reflux disease (GORD, GERD)
3. Surgery is usually indicated once a sufficient period of medical treatment,
i.e. acid reducing medication, has been tried. Patients who respond to
drug treatment but who are dependant on medication for relief of symptoms,
should benefit from surgery
HOW TO MAKE THE DIAGNOSIS
1. Symptoms may include:
ii. Reflux/regurgitaion of food, acid, or bile
iii. Excessive burping/belching
iv. Nausea, vomiting
v. Pain, either upper abdominal, or central chest pain
vii. Voice changes, e.g. hoarseness
2. Investigations may include:
ii. Barium swallow X-ray
iii. Oesophageal motility study
iv. Oesophageal acid monitoring (24 hr pH measurement)
BENEFITS OF SURGERY
Surgery should cure the symptoms of heartburn, reflux and hiatus hernia,
and prevent possible complications of reflux disease, and hiatus hernia
HOW WILL MY BODY FUNCTION AFTER THIS PROCEDURE?
Early in the post-operative period some difficulty in swallowing solid
or chunky food may be encountered. Patients are, therefore, advised to
stay on fluids or a sloppy diet for the first 2-4 weeks, and then slowly
increase their volume of food and build up to more solid food.
Meals will need to be smaller, initially, as patients will usually feel
full sooner. This may result in loss of between 5 and 10 kg of weight
in the early postoperative period (1 to 3 months). The volume of food
will usually increase over a period of 6 - 12 months to what it was before
(or close to this), and the patient's weight will often pick up accordingly
to what it was before.
Some patients feel bloated after meals, and this should also improve with
Increased flatulence may be encountered.
More than 95% of patients should be satisfied after their operation.
Anaesthetic: General Anaesthetic
Operation time: 30 - 90 minutes
Hospital stay: 1 - 3 days
1. difficulty swallowing
Some patients feel food getting stuck as it goes down past the new valve.
This should be temporary and will improve with time until swallowing is
back to normal.
2. "gas bloat"
T this is the feeling of gas trapped in the upper abdomen after a
meal.Usually occurs only with overeating or eating too fast early on after
the operation. This symptom should improve with time.
See general complications of laparoscopic surgery
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