A hiatal hernia occurs when a person’s esophageal hiatus is enlarged. This opening typically allows food and other material to pass from the esophagus and into the stomach.  When the opening is too large, it can allow the stomach and its contents to move in reverse, pushing up into the esophagus through the diaphragm. There are four types of hiatal hernias; type I (sliding) hiatal hernia, type II (paraoesophageal) hiatal hernia, type III (combined) hiatal hernia, and type IV hiatal hernia, which involves organs other than the stomach in addition. The most common type is type I, the sliding hiatal hernia.

There are many symptoms you should be aware of that may indicate you have developed a hiatal hernia. Excessive belching or heartburn, regurgitation or aspiration of stomach contents, stomach twisting and perforation, difficulty or pain when swallowing, and even Hiatal hernias are fairly common and you should know that just because you have a hiatal hernia, doesn’t mean it needs to be fixed. There are many symptoms you should be aware of that may indicate you have developed a hiatal hernia that needs further investigation.  Excessive belching or heartburn, regurgitation or aspiration of stomach contents, and stomach twisting, difficulty or pain when swallowing, and even chest pain could all mean you have a hiatal hernia. Chronic heartburn or reflux is the most common issue associated with a hiatal hernia because hiatal hernias are part of the underlying cause of GERD. Patients with hiatal hernias who also have GERD tend to have worse symptoms.

Depending on your symptoms, your doctor may perform a variety of different tests to determine whether you have a hiatal hernia. Chest x-rays, esophagram, upper endoscopy, Bravo pH testing and esophageal manometry can provide different information regarding your diagnosis. These tests are designed to assess the function of your esophagus and lower esophageal sphincter (LES), as well as identify anatomic abnormalities such as a twisting of the stomach in large hernias and unveil related issues.

While open surgery was long the only option for hiatal hernia repair, constantly improving surgical techniques now offer minimally invasive procedures that can effectively repair hiatal hernias while reducing patients’ recovery time. Dr. Alfred B Johnson utilizes robotic assisted surgery that allows for effective repair of hiatal hernias with tiny incisions. The robotic platform allows the surgeon to have superior visibility with HD image quality in a 3 dimensional format. The Esophyx device is used in combination with a flexible endoscope and allows Dr. Johnson to perform the TIF procedure also known as transoral incisionless fundoplication. The TIF procedure restores the anti-reflux flap valve from inside the stomach. This allows our patients to recover more quickly and comfortably following their procedure than from a traditional open surgery. Concomitant TIF or cTIF simply means that the hiatal hernia is repaired by robotic surgery and is followed by the TIF procedure. The surgery typically takes one and a half to 2 hours. Dr. Johnson is able to provide this service as an outpatient procedure however depending on your own medical history, an overnight stay may be recommended.

If you are in need of surgical repair for a hiatal hernia, contact the office of Alfred B Johnson, MD to schedule a consultation today. Our dedicated medical staff specializes in minimally invasive gastro surgery techniques that can repair hiatal hernias and address a wide range of other gastrointestinal issues to help you recover quickly and live your life to the fullest without the uncomfortable symptoms of hiatal hernia, GERD, or other conditions.