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Hiatal(or Hiatus) Hernia

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What Is Hiatal Hernia?

A hiatal hernia is when a part of the stomach bulges up into your chest through a weakness/opening in the diaphragm, the muscle that separates the two areas. The opening is called the hiatus, so this condition is also called a hiatus/hiatal hernia.

Not everyone with a hiatal hernia develops symptoms, but if you have a hiatal hernia you are more prone to suffer from acid reflux into your oesophagus, which can cause heartburn and other symptoms as well.


What are the Types of Hiatal Hernia?

There are generally two types of hiatal hernia:

Sliding Hiatal Hernia

Sliding hiatus hernia is the most common type of Hiatal Hernia. Sliding hiatal hernias occurs when the stomach and the section of the oesophagus that joins the stomach slide up and down, in and out into the chest through the hiatus. This type of hiatus hernia tends to be associated with symptoms of acid reflux.

Para-oesophageal Hiatus Hernia

Para-oesophageal hiatus hernia (also called a rolling hiatus hernia) is less common, but can be more concerning. In this situation, a part of the stomach protrudes up through the hole in the diaphragm next to the oesophagus. Other organs from the stomach can also protrude through the hole in some cases. It is riskier, as there is an increased chance that the organ protruding can get stuck, and blood flow to your stomach could become blocked. If that happens, it could cause serious damage and is considered a medical emergency which requires immediate medical attention.

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When do I need surgery for my Hiatal Hernia?

While hiatal hernias can often be treated with lifestyle changes or medication, some patients may require surgery to repair their hiatal hernias.

Depending on your condition, your Hernia Surgeon may recommend one of the following surgical treatments:


Hiatus Repair Surgery

Hiatus hernia repair surgery is usually done via minimally invasive procedures such as laparoscopic surgery. This procedure may involve pulling your stomach down into your abdomen and making the opening in your diaphragm smaller or reconstructing an esophageal sphincter.


Nissen Fundoplication (Total 360° Wrap)

Typically known as the ‘gold standard’ for treating GERD in patients who don’t respond well to medications, this procedure involves using stitches to wrap the top part of the stomach, called the fundus, around the bottom portion of the oesophagus. This then helps to hold the stomach in place below the diaphragmatic hiatus, preventing reflux of food and gastric juices.


Partial Fundoplications

Dr Kan is also well versed in partial fundoplications such as Dor (anterior 180° - 200°) and Toupet (posterior 270°) fundoplications. In these procedures, the fundus is not completely wrapped around the bottom of your oesophagus.

Open For Appointments

Depending on your condition and severity of your GERD and Hernia, Dr Kan will present the best treatment options for you.Hiatal Hernias should not be something to be taken lightly. When in doubt, consult experienced Hernia Surgeon in Singapore Dr Kan today!

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