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Paraesophageal Hernia

Paraesophageal hernia occurs when a large portion of your stomach is pushed through the hiatus (opening in the diaphragm) and into your chest cavity. This condition can be associated with GERD, difficulty swallowing, pain, anemia, and can result in more serious complications.

Tests & Diagnosis

Sedated or unsedated endoscopy with biopsy collection is routinely performed in order to visualize your esophagus and stomach to look for the presence of hernia and screen for Barrett’s esophagus. 

pH acid monitoring is a disposable capsule placed into your esophagus using an endoscope. It wirelessly transmits information about esophageal acid levels to a receiver worn around your waist for 48 hours.

High resolution manometry measures the strength, pressure and coordination of your esophagus' muscles. A specially trained nurse guides a small catheter through your nose and into the esophagus and instructs you to swallow small amounts of liquid at specific intervals.

A 24-hour impedance catheter is used to measure the reflux of fluid and gauge its proximity to your voice box. This test is typically used for patients who are experiencing cough, respiratory or non-classical GERD symptoms. A small catheter is inserted through your nose and records data in receiver worn around your waist during while you conduct your regular daily activities.

 

Treatments

Minimally invasive surgery is used to correctly reposition your stomach back into the abdominal cavity and repair the opening in the diaphragm. Patients also undergo a fundoplication to cure their GERD.

Laparoscopic fundoplication: There are several variations in fundoplication including complete (360-degrees) and partial (270-degrees) that wrap the lower esophagus with the floppy upper part of the stomach for a short distance (2 centimeters) to strengthen a weak sphincter muscle and prevent stomach contents from backing up into the esophagus. We perform this laparoscopically through very small external incisions. The operation typically lasts one to two hours and patients go home after 24 hours.