Latest Approach to Treating Hiatal


A hiatal hernia occurs when part of your stomach pushes upward through your diaphragm. Your diaphragm normally has a small opening (hiatus) that allows your food tube (esophagus) to pass through on its way to connect to your stomach. The stomach can push up through this opening and cause a hiatal hernia.

Hiatal hernias are very common, affecting about 15 percent of Americans. Several factors that contribute to the condition are increasing age, obesity, and smoking. The majority of individuals with hiatal hernia are over 50 years old.

For approximately 50% of cases, symptoms are not present and you may not even know you have the condition. But larger hiatal hernias can cause food and acid to back up into your esophagus, leading to heartburn and chest pain. Many individuals with hiatal hernia may also have gastroesophageal reflux disease (GERD).

consult buttonTreatment Options

Patients with hiatal hernia can try to alleviate symptoms by taking over-the-counter medication or prescription medication, losing weight, changing their diet, and avoiding smoking. If these actions fail to control the symptoms or complications appear, surgical repair of the hernia may be necessary.

Nissen fundoplication is a surgical procedure used to treat larger, symptomatic hiatal hernia and reflux. During fundoplication surgery, the upper curve of the stomach (known as the fundus) is carefully wrapped around the junction of the esophagus and stomach and sewn into place. This creates a barrier that prevents the flow of acid into the esophagus. The hiatal opening is also reduced in size with sutures.

Nissen fundoplication can be done as either traditional "open" surgery or a laparoscopic procedure. The open procedure involves an incision of about 8 inches in the abdomen, while the laparoscopic approach is a minimally invasive technique using significantly smaller incisions.

Robot-Assisted Surgery

Boulder Community Hospital offers the latest approach to treating hiatal hernia -- robot-assisted Nissen fundoplication surgery with the da Vinci® Surgical System.  Benefits of da Vinci surgery include:

  • Significantly less pain
  • Potentially less blood loss
  • Fewer complications - including reduced risk of infection
  • Less scarring – 1-2 cm incisions versus 8 inches with open surgery
  • Shorter hospital stay
  • Quicker recovery from surgery and return to normal routine

The state-of-the-art da Vinci robot allows some complex surgeries to be performed as minimally invasive procedures. Through tiny 1-2 cm incisions, a surgeon using the da Vinci system can operate with precision and control while minimizing the pain that often accompanies the large incisions associated with open surgery. The surgeon uses special hand controls to guide robotic arms that hold specially designed surgical instruments. The latest computer technology converts the surgeon’s large hand movements into precise small movements, resulting in tremendous dexterity. The robotic "wrists" can rotate a full 360 degrees, enabling your surgeon to control the miniature surgical instruments with unprecedented accuracy, flexibility and range of motion. The da Vinci System requires that every surgical maneuver be performed with direct input from your surgeon – the machine cannot move on its own.

The three-dimensional, high definition da Vinci camera supplies your surgeon with a magnified view of the internal organs that’s better than normal vision. The enhanced visualization and greater degree of movement offered by the da Vinci System provides a minimally invasive alternative that offers many advantages for Nissen fundoplication surgery.

For more information on the da Vinci System’s leading-edge robotic technology, click here.

Contact a general surgeon to find out if robot-assisted surgery may be your best treatment option.

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