Hiatal Hernia

The presence of a hiatal hernia is a well-known risk factor for symptomatic gastro-esophageal reflux disease (GERD). Morbidly obese patients have a risk of developing a hiatal hernia approaching nearly 40%; however, classic surgical repair of a hiatal hernia including crural closure and fundoplication is generally avoided in patients with a BMI>35 due to unacceptably high failure rates.

The Procedure

It has been advocated that a Hernia Hiatal found at the time of bariatric surgery SHOULD BE REPLACED as failure to do so may worsen GERD symptoms over time. The concomitant hiatal hernia repair at the time of a Sleeve Gastrectomy and Roux-en-Y gastric bypass (RYGB) is safe, well-tolerated, and with minimal additional cost.
A hiatal hernia found at the time of sleeve gastrectomy should be repaired during the index operation, otherwise the upper portion of the stomach that has been slide through the thorax will act as a stretch pouch ending in weigh loss failure. Crural repair with sleeve gastrectomy provides control of gastroesophageal reflux disease (GERD) and weight loss.

In some cases where patients suffer from severe acid reflux might get better control for GERD symptoms choosing a Bypass Roux-en-Y rather than having a sleeve gastrectomy, GERD symptoms are caused by multiple reasons such overweight, hiatal hernia, alcohol, medication, etc.

Please contact us to find out which procedure suits you best if you are suffering from acid reflux.

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