Not many people know that hiatal hernia repair surgery and sleeve gastrectomy (gastric sleeve) can be combined into a single procedure.
If you suffer from morbid obesity and want to repair your hernia while fighting obesity with the gastric sleeve, you’ll want to request a single surgical session for both techniques.
Here is everything you need to know about the combination of two-in-one hernia repair and bariatric surgery that can save you time and money while improving your health.
What is Hiatal Hernia Repair Surgery?
Before we begin exploring how these two amazing procedures work together, it helps to define them one at a time. Let’s start with Hiatal hernias, which are more common in morbidly obese patients.
A hiatal hernia (or hiatus hernia) happens when the upper part of your stomach bulges through the muscles separating your chest from your abdomen. That area of your chest is known as the diaphragm. It contains a small opening called a hiatus, where food passes through the esophagus on its way to your stomach.
When you have a hiatal hernia, your stomach pushes through the hiatus and into your chest.
Most people experience no symptoms from this bulging of the stomach and separation of the muscle. You might only discover you need hernia repair surgery when your doctor checks for something else, such as your eligibility for gastric sleeve surgery.
Then, there are people with extreme heartburn caused by a hiatal hernia. If you are one of these people, you may also experience gastroesophageal reflux disease (GERD), when food and acid regurgitate into the esophagus.
The esophagus usually has sphincter muscles that can close to prevent backup. The hiatal hernia prevents the sphincters from closing properly, leading to heartburn that doesn’t seem to disappear.
While heartburn and acid reflux are common experiences, if you are morbidly obese, these symptoms may indicate a more serious problem. Hiatal hernias can cause frequent and intense heart; surgery is often needed if left untreated.
What Causes a Hiatal Hernia?
You may be wondering how a hernia begins in the first place. You don’t just wake up one day with your stomach pushing through your chest and causing problems, though you could be born with a larger hiatal opening.
Morbid obese patients have a 50% chance of developing a hiatal hernia (and GERD). Various factors can cause the condition, mostly increased pressure on the abdomen, which can be caused by extreme vomiting, straining during bowel movements, and heavy lifting. Hacking bouts of coughing can also cause you to develop a hiatal hernia.
Pregnant and obese women are at higher risk of developing a hiatal hernia.
What is Gastric Sleeve Surgery (Sleeve Gastrectomy)?
One of the more popular bariatric surgeries is the Gastric Sleeve or laparoscopic sleeve gastrectomy. This surgery will shrink your stomach, limit your food intake, allow you to feel full faster, and ultimately result in major weight loss.
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The surgery is incredibly popular for treating obesity and is backed by the FDA. Most importantly, the surgery can lead to long-term weight loss, but only if the obese patient follows a healthy lifestyle. How is the Hiatal Hernia Repaired?
Hiatal hernia surgery aims to pull your stomach back into your abdomen while simultaneously making the diaphragm opening smaller. The procedure can also involve the reconstruction of the esophageal sphincter or the removal of hernia sacks.
The surgery is performed laparoscopically via tiny incisions made in your abdomen. Because the surgery is minimally invasive, it comes with a quick recovery period and a decreased risk of infection.
Your surgeon will make between three and five incisions in your abdomen that will be openings for the surgical instruments.
The laparoscope will guide Your surgeon’s actions and be shown on an HD monitor positioned nearby. This allows the doctor to view your internal organs and pull your stomach back to the desired position, where it belongs.
Your doctor will wrap your stomach’s upper part around the esophagus’s lower part. The result is a tighter sphincter that prevents acid reflux from recurring.
The hiatal hernia repair surgery has a 90% success rate. However, unfortunately, 30% of people will experience a return of their acid reflux symptoms.
How is the Simultaneous Sleeve Gastrectomy Performed?
We can perform the gastric sleeve using the same laparoscopic instruments. Your bariatric surgeon will begin on your sleeve gastrectomy before or after the hernia has been repaired.
Your surgeon will remove 75% of your stomach, which leaves behind a narrow tube. The tube looks like a sleeve where LSG gets its name. This sleeve looks like a banana and will store your food before digestion occurs.
Unlike bariatric procedures like the gastric bypass, where your digestive process is rerouted, the gastric sleeve doesn’t work this way. Only your stomach is affected.
The surgical session lasts up to two hours, leaving you with limited stomach space to help you adopt healthier eating habits. You won’t be able to help but eat smaller, healthier portions. At the same time, the resulting hormonal changes cause you to feel less hungry and “fuller” faster whenever you are eating. Surgery has many benefits, including fast and safe long-term weight loss.
Combining Hiatus Hernia Repair Surgery and Gastric Sleeve – Does it Work?
Does the procedure work together? In 2010, a study was conducted over 18 months that followed eleven obese patients after undergoing laparoscopic sleeve gastrectomy (LSG) and Hiatal Hernia Repair (HHR). The mean weight between all the participants was roughly 276 lbs. with a body mass index (BMI) of 44.75.
Ten out of the eleven patients had GERD. One patient had no symptoms at all. That person’s hernia was only discovered during an unrelated surgery.
In addition to GERD, five patients showed evidence of chronic gastritis.
All the patients were treated with LSG and HH, with no signs of complications.
The surgical procedures combined offer excellent results. Eight of the eleven patients stopped experiencing GERD symptoms entirely after the operation.
Four of the six quit taking their anti-reflux medication.
Two patients had a decrease in symptoms but continued using proton pump inhibitors.
The study research staff concluded that combining LSG with HHR is safe and provides excellent outcomes for patients with morbid obesity and GERD.
What is the Average Cost of Hiatal Hernia Repair and Gastric Sleeve Surgery Combined?
Undergoing sleeve gastrectomy will set you back about $17,500, on average. The surgery to repair a hiatus hernia costs around $5,000. Combining the surgeries should come with a healthy discount. Schedule a consultation with a qualified bariatric surgeon for a more accurate quote.
Are There Any Risks or Complications Related to Surgery?
Simultaneous repair and gastric sleeve surgery come with their own risks. You have the typical risks accompanying any surgery, such as infection, but both surgeries are common and safe for a qualified surgeon.
How Do You Find the Best Hiatal Hernia Repair & Gastric Sleeve Surgeon?
Your first step to gaining independence from GERD is to have reflux surgery using this effective bariatric combination. Combining hiatal hernia repair and gastric sleeve surgery helps you live a life free of obesity and acid reflux.
Dr. Moeinolmolki of Healthy Life Bariatrics invites you to schedule a virtual consultation to discuss HHR and LSG.
If you have a high body mass index and are experiencing hiatal hernia symptoms like GERD or more extreme symptoms like bleeding, call 310-807-1735 and book a time that works best for you.