Mary from Humble, TX sent us this question: “I have a Hiatal Hernia with Achalasia. Can surgery on these be done at the same time? What type of surgeon does these? A GI doctor, Thoracic Surgeon, or regular Surgeon? I live around Cypress, Humble area.” Thanks, Mary Dear...
Lina from Baytown sent us this question: “Hi I am 49-year-old Hispanic women with a long medical history. Systemic Lupus, history of a stroke at 32, kidney failure at 27 and Barrett’s Esophagus among others. I am considering hiatal hernia repair. My GI has advised...
Question of the week from Reginald in Houston: I had surgery for hiatal hernia in 2014. I re-experienced reflux after 15 months and began taking Omeprazole. This seemed to work. In the last 4 months other symptoms have begun and my surgeon had me go...
Case Presentation: Allen is a pleasant 60-year-old male with new onset heartburn, food regurgitation, bloating and excessive burping. He is otherwise healthy and maintains a healthy lifestyle. 6 months prior to presenting to Houston heartburn and Reflux Center, Allen started heavy weight lifting. He was...
Natalie from Houston sent us this question: Do you recommend fundoplication in a patient with severe esophageal dysmotility and a paraesophageal hiatal hernia? Or is repairing the hernia the best that can be done? Dear Natalie, Your question is common and quite relevant. Why add a fundoplication...
I read with great interest the new study “Patient-Centered Outcomes after Laparoscopic Paraesophageal Hernia Repair” by Ujiki et al published in the current issue of JACS (Journal of the American College of Surgeons). 314 patients who underwent laparoscopic hiatal hernia repair were prospectively followed between...
Hiatal hernia surgery requires complete phrenoesophageal membrane dissection and proper esophageal mobilization. The phrenoesophageal membrane and hernia sac must be dissected and completely resected to allow for circumferential esophageal mobilization. The esophagus must be dissected free of mediastinal adhesions until obtaining at least 3 cm...
C.M. is a 71-year-old patient with worsening GERD related symptoms of 30-year duration. After years of proton pump inhibitor therapy, she has stopped responding to medical treatment and decided to seek more effective GERD treatment options. An upper endoscopy with ambulatory pH testing showed a...
There is widespread belief that hiatal hernia repair and Nissen fundoplication are a last resort for GERD patients. Indeed, most primary care physicians and gastroenterologists do not refer a GERD patient for surgery until it is too late. GERD patients are typically subjected to escalating...
Nissen fundoplication with hiatal hernia repair is the most reliable and most effective treatment of GERD or acid reflux disease. The procedure is also very safe with less than 1% complication rate. Gastroparesis or delayed gastric emptying is a poorly understood medical disorder. Gastroparesis results...