Hiatal Hernias

Started by MacGyver
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MacGyver

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Someone I know has been diagnosed with this (dont know which type, paraesophageal, or sliding).

He had symptoms of GERD, and later had difficulty swallowing.

Apparently, the surgeons decided that it needed treatment.

They "wrapped his esophagus" as part of the surgery, and he has had 3 separate surgeries.

1) Is it normal to require 3 surgeries to fix a hiatal hernia? I was under the impression that these are easily fixable by laparascopy.

2) What is "wrapping the esophagus"?
 
1) Hard to answer without particulars of the case: what type of hiatal hernia, grade, whether there were complications with the original surgery, etc.

2) "Wrapping the esophagus" probably refers to a Nissn fundiplication, where the fundus of the stomach is twisted around the distal esophagus and stapled in place in order to try and reduce the reflux of acid into the distal esophagus.
 
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3 surgeons? they must really suck!!!! this should be an easy procedure. There is this guy my school that does it with Lap. Should'nt take 3 of them!
 
Actually Nissens (mostly done laparoscopically these days), as simple as they may seem, have a relatively high complication rate. A lot of times they become too tight, or they "open up", sometimes requiring reoperation. I've seen a few EG junction leaks as well, although this one should be rare, but I guess the reason we see it every now and then could possibly be because it's done in a training intitution.