Minimally Invasive Hiatal Hernia Surgery helps large portions of society recover

Field of Medicine: General Surgery

By Nick Rees

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Approximately 15 percent of Americans have hiatal hernias, which is when the stomach protrudes through the diaphragm and into the chest.

"Essentially, the food that you eat goes through your mouth and travels down to your stomach through the esophagus," Dr. Scott Otto, MD, selected as a Chicago Top Doctor by TopTierMD as a top rated general surgeon in Chicago, said. "The esophagus passes through the diaphragm, which has the major function of helping with breathing. There's a hole in the diaphragm that allows the esophagus to pass through into the stomach.

"A hiatal hernia is when a portion of that hole allows the stomach to migrate up into the chest."

There are many causes of hiatal hernias, Dr. Otto said, including genetic causes, obesity, the use of steroids, and anything that would increase anti-abdominal pressure.

There are four types of hiatal hernias. Type one hernias often do not require surgery, while the other three types generally do. For types two through four, a large portion of the stomach has often migrated into the chest and is at risk of twisting onto itself and cutting off its blood flow. When that happens, the stomach can necrose, or die.

"People with significantly sized hiatal hernias can sometimes have a hard time eating," Dr. Otto said. "Some people lose weight. I've had patients that have had bleeding problems and were becoming anemic from blood loss.

"I see hiatal hernias more commonly in older patients, although I do see a fair number in younger patients. Fortunately, they can often be treated with medication and don't need to be fixed surgically. If it doesn't respond with medication, it may need surgery."

Hiatal hernia surgery is minimally invasive. The goal of the surgery is to narrow the hole where the esophagus comes through the diaphragm by using an internal stent. The hole is then sewn around the stent, which keeps it from being tied too tightly and allows for normal eating and swallowing.

"After surgery, I put my patients on dietary chances for six to eight weeks, and then they gradually go back to regular food," Dr. Otto said. "We're always trying to avoid straining and heavy lifting for six to eight weeks after surgery to allow the hernia to heal and to minimize the risk of going back."

Dr. Scott Otto, MD, was selected by TopTierMD as a Chicago Top Doctor and is considered Best in General Surgery in Chicago. He specializes in advanced laproscopic minimally invasive surgery, colon resectioning and hiatal hernias.

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