Paraesophageal Hernia/Hiatal Hernia | White Plains Hospital

Paraesophageal Hernia/Hiatal Hernia

There are certain diseases of the esophagus that are not cancers but do require surgical attention. These diseases include achalasia, gastroesophageal reflux disease (GERD) and esophageal leiomyoma.

Definition

A part of the stomach goes into the chest through a defect in the diaphragm. In larger hernias, a part of the colon or the spleen may also go into the chest.

Symptoms

  • Heartburn - most common symptom
  • Chest pain
  • Heart palpitations
  • Shortness of breath because the stomach in the chest prevents the lung from fully expanding

Diagnostic Tests

Types

  • Type I:
    • The gastoesophageal junction (GEJ) moves into the chest
    • Most commonly known as a sliding hernia
    • Most common type
  • Type II:
    • The GEJ stays in the abdomen but a different part of the stomach goes into the chest
  • Type III:
    • It’s a combination of type I and II. The GEJ and another part of the stomach go into the chest
  • Type IV:
    • In addition to the stomach going into the chest other organs such as the colon or the spleen also migrate into the chest

Treatment

  • Not all hiatal hernias require treatment.
  • Small, asymptomatic Type I hernias may be treated with medicine alone.
  • Type II-IV can be treated laparoscopically.
  • 5 one-inch incisions can be made on the abdomen to allow a camera and special minimally-invasive equipment to be used to perform this surgery.
  • The goal of the surgery is to bring the stomach and the GEJ back into the abdomen and to repair the defect in the diaphragm. Sometimes special material, known as mesh, is used to fix the diaphragm.
  • Patients may be discharged to home 1-2 days after surgery.

At White Plains Hospital, we have a fully staffed Thoracic Surgery Service that includes board-certified thoracic surgeons, anesthesiologists, pulmonologists, gastroenterologists, and critical care intensivists. In addition, we have a staff of highly trained nurses, respiratory therapists, nutritionists, physical therapists, case managers and social workers that work in-sync with your surgeon to provide great care for you when you are recovering from your surgery.