CONTACT US
Fill the form below and we will get back to you as soon as possible.
WHAT IS A HIATAL HERNIA?
A hiatal hernia happens when the upper part of the stomach pushes up through the opening in the diaphragm (the hiatus) into the chest. Small hiatal hernias often cause no symptoms. Larger ones can cause heartburn, regurgitation, chest pain, trouble swallowing or a feeling of fullness after small meals, and many people with a hiatal hernia also have acid reflux (GERD). At North Florida Surgeons in Jacksonville, FL, our surgeons repair sliding and paraesophageal hiatal hernias with minimally invasive laparoscopic and robotic surgery, usually combined with an anti-reflux procedure.
WHY CHOOSE US?
Hiatal hernia repair is part of our anti-reflux and foregut surgery practice. Dr. Craig Morgenthal is Medical Director of the Baptist Center for Bariatric and Reflux Surgery, and our surgeons work closely with gastroenterologists at Baptist Medical Center Jacksonville to test, treat and follow each patient.
Most repairs are done through a few small incisions, so most patients go home the same day or the next morning and return to light activity within a week or two.
When a hiatal hernia is found during an evaluation for weight-loss surgery, it can often be repaired during the same operation. Ask your surgeon whether that applies to you.
TYPES OF HIATAL HERNIAS
SLIDING HIATAL HERNIA
The most common type. The junction of the esophagus and stomach slides up into the chest. It often causes acid reflux and heartburn and is usually treated with lifestyle changes and medicine first.
PARAESOPHAGEAL HERNIA
Part of the stomach pushes up next to the esophagus. These hernias can grow large, and the stomach can twist or become trapped, so surgeons often recommend repair even when symptoms are mild.
LARGE AND MIXED HIATAL HERNIAS
Some hernias have features of both types or contain a large part of the stomach. They need careful planning and are best repaired by surgeons experienced in foregut surgery.
WHEN IS SURGERY NEEDED?
Surgery is usually recommended when reflux continues despite daily medicine, when the hernia is large or paraesophageal, or when there are complications such as bleeding, anemia, trouble swallowing or damage to the esophagus. Compare all treatment options for hiatal hernia.
SYMPTOMS TO WATCH FOR
Heartburn, regurgitation, chest pain or pressure, trouble swallowing, feeling full quickly, shortness of breath after meals, and anemia from slow bleeding. Sudden severe chest or upper belly pain with vomiting and inability to swallow can mean the stomach is trapped. That is an emergency: call 911.
HOW WE REPAIR HIATAL HERNIAS
LAPAROSCOPIC REPAIR
Through four or five small incisions, the surgeon gently brings the stomach back into the abdomen, removes the hernia sac and tightens the opening in the diaphragm with stitches. Most hiatal hernia surgery today is done this way.
FUNDOPLICATION (ANTI-REFLUX WRAP)
A hiatal hernia weakens the valve between the esophagus and stomach, so the repair is usually combined with a fundoplication. The top of the stomach is wrapped around the lower esophagus to stop acid from coming back up. A full (Nissen) or partial wrap is chosen based on your tests.
ROBOTIC-ASSISTED REPAIR AND MESH
For some patients, especially with large hernias, the surgeon may use a surgical robot for a magnified 3D view and precise stitching through the same small incisions. In selected cases, a mesh is used to reinforce the diaphragm repair.
WHAT TO EXPECT
TESTS BEFORE SURGERY
Your surgeon may order an upper endoscopy, a barium swallow X-ray, esophageal manometry (to test how the esophagus squeezes) and pH monitoring (to measure acid). These tests confirm the diagnosis and help choose the right repair. Learn more about anti-reflux surgery.
THE DAY OF SURGERY
Surgery usually takes two to three hours under general anesthesia. Most patients stay one night in the hospital, walk the same day and start with clear liquids.
DIET AFTER SURGERY
You follow a liquid diet for a few days, then soft foods for about two weeks, before slowly returning to normal food. Small meals, small bites and eating slowly help while swelling settles. See our guide to hiatal hernia surgery types and recovery.
RECOVERY
Most people return to light activity and desk work within one to two weeks. Heavy lifting usually waits about six weeks. Some trouble swallowing and bloating is common at first and usually improves over a few weeks.
OUR HIATAL HERNIA SURGEONS
Hiatal hernia and anti-reflux surgery at North Florida Surgeons is performed by board-certified surgeons with advanced training in minimally invasive foregut surgery, including Dr. Craig Morgenthal, Dr. Courtland Polley and Dr. Alexander Rose.
HIATAL HERNIA REPAIR FAQS
Can a hiatal hernia heal on its own?
No. The opening in the diaphragm does not close by itself. Small hernias without symptoms often need no treatment, but larger or troublesome hernias can only be fixed with surgery.
Is hiatal hernia surgery a major operation?
It is done under general anesthesia, but most repairs are minimally invasive through small incisions. Most patients stay one night and are back to light activity within one to two weeks.
Will I still need reflux medicine after surgery?
Many patients are able to stop or reduce reflux medicine after a hiatal hernia repair with fundoplication. Your surgeon will tell you when and how to stop.
Can a hiatal hernia come back after repair?
Yes, a hernia can come back, and the chance is higher with very large hernias. Careful technique, reinforcing the repair when needed, and avoiding heavy lifting while you heal all lower the risk.
Does insurance cover hiatal hernia surgery?
Many insurance plans cover hiatal hernia repair when it is medically necessary, but coverage varies by plan. See the insurance plans we accept or call our office.
How do I schedule a hiatal hernia consultation in Jacksonville?
Call (904) 398-0033 or use the contact form. Our office is at 836 Prudential Dr., Suite 1001, Jacksonville, FL 32207. Related: hernia repair, GERD vs. hiatal hernia.
