Hiatal Hernia Surgery
Introduction
A hiatal hernia develops when a portion of the stomach protrudes from the diaphragm into the chest cavity. Small hiatal hernias may not be symptomatic, but larger hernias can produce very intense acid reflux, chest pain, and dysphagia. If lifestyle modification medications are unsuccessful then surgery may become an option. This article explores hiatal hernia surgery, its procedure, benefits, risks, and associated costs.
What is Hiatal Hernia Surgery?
Hiatal hernia surgery is a medical procedure to repair the hernia by pulling the stomach back into its proper position and reinforcing the diaphragm to prevent future herniation. Depending on the stage of the disease, medical professionals may carry out surgery using minimally invasive (e.g., laparoscopic surgery) or traditional open surgery approaches.
Why is Esophageal hernia surgery Needed?
Hiatal hernia surgery is typically recommended for individuals experiencing:
- Persistent acid reflux (GERD) is unresponsive to medication.
- Difficulty swallowing (dysphagia).
- Severe chest pain or discomfort.
- Breathing difficulties caused by the hernia.
- Complication risk of intestinal kinking/obstruction of the stomach.
Types of Hiatal Hernia Surgery
There are two primary types of hiatal hernia surgery:
Laparoscopic Nissen Fundoplication:
- A magnetic technique for creating a closed circuit of the stomach to strengthen the lower esophageal sphincter and alleviate acid reflux.
Open Surgery:
- A classic way of repair is by using a larger cut down to fix the hernia. This may be necessary for complicated or recurrent cases.
Procedure Steps
The surgical procedure typically involves the following steps:
Preparation:
- Patients undergo pre-operative tests, including imaging and endoscopy.
- Fasting is required before surgery.
Anesthesia:
- General anesthesia is administered to ensure patient comfort.
Hernia Repair:
- The stomach is shifted and the opening in the diaphragm (hiatus) is constricted.
Reinforcement:
- When necessary, a mesh can be incorporated with the diaphragm to stabilize it.
Closure:
- The incision is made and closed and the patient is transferred to recovery.
Benefits of Hiatal Hernia Surgery
- Relief from chronic GERD symptoms.
- Higher quality of life with improved chest pain and dysphagia.
- Prevention of complications like strangulation or obstruction.
- Long-term solution compared to ongoing medication use.
Risks and Complications
Although safe, hiatal hernia surgery has potential risks including:
- Infection or bleeding.
- Adverse reactions to anesthesia.
- Recurrence of the hernia.
- Difficulty swallowing (temporary or long-term).
- Damage to adjacent structures e.g., esophagus or stomach.
Cost of Treatment in India Compared with the USA
Hernia surgery prices differ widely between India and the USA:
India:
- Cost: $2,500 – $5,000 (INR 2,00,000 – 4,00,000).
- Includes surgeon fees, hospital stay, and post-operative care.
USA:
- Cost: $10,000-$20,000 or more.
- Higher due to expensive healthcare systems and insurance variations.
India provides low-cost, quality surgical treatment and hence this is a desirable location for medical tourism.
Top Hospitals in India for Esophageal hernia surgery
- Apollo Hospitals (Chennai, Delhi, Bangalore): Renowned for advanced laparoscopic surgeries.
- Fortis Healthcare (Mumbai, Gurgaon, Bangalore): Equipped with state-of-the-art facilities and experienced surgeons.
- Max Healthcare (Delhi, Noida): Known for high success rates in minimally invasive procedures.
- Manipal Hospitals (Bangalore, Hyderabad): Offers comprehensive gastrointestinal care.
- AIIMS (Delhi): Provides affordable and high-quality treatment.
