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Forum Name: Gastroenterology Topics

Question: Paraesphoegal (sp?) Hiatal Hernia


 Cindisu - Sun Sep 07, 2008 6:47 am

I have a Paraesphoegal Hiatal Hernia. I had one repaired about 8 years ago and had the new Laproscopic Nissen Procedure done. The Hernia has come back but is much larger and is up behind my ribs and my heart. The Surgeon now says he can not do this surgery again Laproscopically. He says it has to be done by a Thorasic Surgeon who will open my rib cage and then they both will assist in bringing my stomach back down to where it should be. He said that he will suture it this time as he think I must have a very weak diaphram.

My question is this......does this surgery really have to be done this way. I dread having my chest opened up and chest tubes inserted. I am scared to death.

I also requested a peg tube insert as I can not tolerate the gastric tube going down the nose and into the stomach.

I have put this surgery off now for almost two years. I saw my Gastro doc two weeks ago and he said I am a walking time bomb. He said that it could rupture at any time or my stomach could die off. Either way the complications are HUGE and survival he says is difficult.

Please any feedback regarding this complication would be greatly appreciated. Any doctor who recommends another method or recommends a Surgeon on the East Coast that possibly specializes in this procedure would be greatly appreciated.

Thanks.
 Dr. Safaa Mahmoud - Sat Oct 25, 2008 4:10 pm

User avatar Hello,

It is true that when medical treatment and laparoscopic surgery fails many surgeons recommend early elective surgery to prevent complications.

Severity of symptoms due to hiatus hernia is not an indicator that complications are about to occur. Complications may occur with no warning signs. Complications are serious in the form of obstruction, strangulation, perforation and hemorrhage.

Surgeons chose laparoscopic or open technique depending on the presence of complications like distorted anatomy and fibrotic weak fragile wall.

Each has its own indications and complications that you can discuss freely with your doctor.

But once surgical repair is indicated I advise you to do it to avoid emergency surgery that is for sure associated with high and serious complications.

I would advise you to follow up with your doctor and to discuss your concerns with the surgeon.

Please keep us updated.
Best regards.

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