Paraesophageal Hernia Repair

Paraesophageal hernia is a rare but serious condition in which the stomach (and occasionally other abdominal organs) pushes up, or herniates, through an abnormally enlarged opening in the diaphragm into the chest cavity. This is considered a type of hiatal hernia, but it is one that can cause far more serious symptoms and consequences than those of the common hiatal hernia (sliding hernia) which is generally associated only with heartburn. The symptoms of a paraesophageal hernia can range from trouble swallowing to severe chest pain following a meal, regurgitation of food, heartburn, chronic blood loss and even strangulation of the stomach can occur. The traditional operation involves either a long incision through the chest or one through the abdomen or sometimes both. Usually, persons with this problem are elderly and have a variety of medical problems making major surgery risky. Laparoscopic repair of paraesophageal hernia is a minimally invasive procedure and offers a lower incidence of complications, a shorter hospital stay, and a quicker and less painful recovery. The repair involves pulling the stomach back down into the abdomen, removing the hernia sac, narrowing the opening in the diaphragm and usually fixing the stomach to the diaphragm with funduplication.