hiatal hernia : New Surgical Treatment

Hernia repair is one of the most commonly performed surgical procedures worldwide. In fact, there are over 600,000 hernia repair surgeries performed each year in the U.S. alone. A hernia is a weakness or defect in the abdominal muscles which can result in the protrusion of tissue through an opening in the outer layers of the abdominal wall. Hernias can develop at any part of the abdominal wall, but generally occur in areas that have a natural tendency to be weak. These areas include the groin (inguinal hernias), umbilicus (umbilical hernias), hiatus (hiatal hernias) and incisions from previous surgeries (incisional or ventral hernias). While hernias generally do not pose serious long-term health problems, they can cause severe pain and discomfort for those suffering from this condition.

Hernias may be present from birth, or can be caused by strain on the abdominal muscles. In either case, hernias do not go away by themselves and depending on the degree of bulging or pain, generally require a surgical procedure to be repaired. Hernia repairs are usually done on an elective basis, which means that the patient and physician decide whether or when the procedure should be performed. Emergency procedures are only done for strangulated hernias, which are hernias that have become pinched to the point that the blood supply is cut off. These hernias require immediate medical attention since they can become infected and lead to a life threatening condition very quickly.


Hernias are typically repaired through a surgical procedure called herniorrhaphy, in which the surgeon repairs the hole in the abdominal wall by sewing surrounding muscle together or by placing a patch called "mesh" over the defect. Most surgeons make an incision at the site of the hernia in order to gain access to the defect, although some surgeons prefer to do these procedures laparoscopically.


During a laparoscopic hernia repair, the surgeon makes very small incisions to pass through specialized instruments and an endoscope, a device that allows the surgeon to see the abdominal area without opening the patient up. Laparoscopic hernia repair generally results in less postoperative pain and recovery time than open surgery. There is still a great deal of controversy over the long-term benefits of laparoscopic hernia repair, however, and it is by no means an option for every patient.

by Joseph R. Lopez