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Tag: hiatal hernia

Pictures For Anesthesia

February 02, 2022 11:57 am

One consideration for anesthesia in weight loss surgery is “airway management.” A sleep and paralyzed patient loses the ability to breathe because of the medication given for general anesthesia. For this, a temporary breathing tube is placed. The breathing tube is then connected to the machine, where the oxygen is pumped in, and the carbon dioxide is removed. An anesthesiologist assesses the mouth and neck before the operation to evaluate the pertinent anatomy’s length, size, and position. This will dictate the instruments needed to insert the appropriately sized tube The anesthesia staff may sometimes want pictures of your neck reviewed before surgery. If asked for photos of the neck, please take images similar to the one below and email them to contact@dssurgery.com.  

Reflux and Hiatal Hernia

April 17, 2017 9:41 am

One of the leading reasons for Gastro-esophageal reflux disease (GERD) is a physical defect called a Hiatal hernia. The esophageal Hiatus is the opening in the diaphragm where the esophagus enters from chest cavity allowing the esophagus to pass into the abdominal space. If the opening in the diaphragm is much larger than the esophagus, it will result in reflux of the stomach secretions and food from the stomach into esophagus. *Note: Graphic surgical pictures below

Hiatal Hernia Causes:

  • heavy lifting
  • coughing
  • obesity
  • injury
  • persistent vomiting
  • age related

Reflux and Hernia Symptoms:

  • sour taste
  • reflux
  • heartburn
  • belching
  • chest or abdominal pain
  • difficulty swallowing
  • vomiting
  • no symptoms
Anatomical picture of Hiatal hernia with reflux
Anatomical picture of Hiatal hernia with reflux
Surgical repair of Hiatal hernia causing reflux
Surgical repair of Hiatal hernia causing reflux

The treatment includes dietary changes, medication and in those who do not improve surgery.

Hiatal hernia repair includes tightening of the dilated opening of the esophageal hiatus by re-appoximating the separated muscle fibers of the right and the left crus. This tightens the defect in the diaphragm and helps prevent part of the stomach or stomach contents from entering the chest cavity.

You can find further information and dietary changes regarding Hiatal Hernia and GERD here, including information unique to weight loss surgery and Hiatal Hernia. You can also find further surgical information, as well as a surgical video here.

Hiatal Hernia Treatment

February 13, 2016 4:45 pm

Hiatal Hernia may be one reason for developing symptoms of GERD (Gastroesophageal reflux disease). As we have discussed previously, the treatment for reflux should not be long-term use of the “purple pill”, or all PPI’s, as advertised on TV. There is a large population who are delaying  definitive care and probably increasing their chance of esophageal cancer by taming the  symptoms of the reflux with over the counter or prescription medication.  However, it is important to note that taming the symptoms isn’t necessarily stopping the effects. Be proactive and request to be sent to a surgeon to fix any issues if you are being recommended to “….take the medication and come back again for another endoscopy  again ….”

Types of Hiatal Hernia:

Hiatus Hernia Types

This is an example of a patient who had  been told to take the medication and just keep and eye on it with repetitive endoscopies.  He had to have hiatal hernia repair with  Nissen fundoplication for progressively worsening symptoms even on maximum treatment.

Surgical View of Hiatal Hernia
Surgical View of Hiatal Hernia

This is another example of a hiatal hernia repair procedure  of a patient with a previous history of sleeve gastrectomy.  In this patient, mesh had to be placed in order to fix the hiatal hernia.

Adjustable Gastric Band Removal & Hiatal Hernia Repair

April 21, 2015 6:30 pm

As it is a recurrent theme, a patient presents with a band that was placed years ago with marginal weight loss over a short period of time. Multiple office visits to the same center for band adjustments, which only results in worsening nausea, vomiting and reflux to the point of having difficulty with taking fluids in. The irony was that the patient was being blamed for the symptoms as to “…eating the wrong food, …eating too much, etc” The patient presented to the Emergency Room and was taken to the Operating Room within few hours for a partially slipped band and a Hiatal Hernia was also identified. The adjustable gastric band was removed and the Hiatal hernia was repaired.

Screen-Shot-2015-04-16-at-12
Screen-Shot-2015-04-16-at-12.10

The band in place and after being taken down

Screen-Shot-2015-04-16-at-12.10-1
Screen-Shot-2015-04-16-at-12.1012

The dissection of the wrap over the band that shows erosion

Screen-Shot-2015-04-16-at-12.11

Part of the hiatal hernia repair.

Screen-Shot-2015-04-16-at-12.1115

The band and the port removed.

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