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Hiatal hernia surgery
With the development of proton pump inhibitor medications, medical therapy
has decreased the necessity of surgery for sliding hiatal hernias, and it is
often only recommended for people who have failed aggressive drug treatment or
who have developed complications of GERD like strictures, ulcers, and bleeding or
those with repeated pneumonia form aspiration.
Patients with paraesophageal hernias often have no symptoms, and surgery is
required only if the hernias become incarcerated and become stuck in the
diaphragmatic hiatus or rotate to cause a volvulus. While this is more commonly
seen in older people, paraesophageal hernias also may occur as a congenital
condition in neonates and infants.
Most often, the surgery is done as a minimally invasive procedure using a
laparoscope. While there are different techniques (Nissen, Belsey or Hill), the
results are similar and the option recommended is the one the surgeon feels most
comfortable performing in a specific situation.