Hiatal hernia surgery is a delicate procedure that requires expert care and thoughtful preparation. For anyone considering undergoing this complex surgery, it is important to understand the risks associated with it, what to expect during the surgery, and what recovery will look like afterward. This article will provide an overview of hiatal hernia surgery, including what to expect before, during, and after your procedure, as well as the various types of surgery available and the risks associated with them. We’ll also address what you can do to prepare for the surgery and the pain management techniques to help you through the recovery process.

What is Hiatal Hernia Surgery?

Hiatal hernia surgery is a procedure that is typically done to repair a hernia located in the diaphragm. During the procedure, the surgeon is able to push the hernia back into the abdomen and then close the hole or provide further support with a mesh patch or stitches. Some people may also require their stomachs to be lifted in order to provide additional support. Depending on the type of hernia, the surgery can take anywhere from one to two hours to complete.

Risks Associated With Hiatal Hernia Surgery

Hiatal hernia surgery is a major medical procedure that carries certain risks with it. Those risks may include infection, blood clots, difficulty swallowing or breathing, or unintended damage to other organs during the procedure. Your doctor will be able to best explain the risks associated with hiatal hernia surgery and provide you with the best advice on how to prepare for the procedure. In order to reduce your risks, you may be advised to stop taking certain medications and to make lifestyle changes before the surgery. It is important to discuss all risks with your doctor before the surgery and to follow their instructions on how to prepare.

Gastrointestinal Bleeding

Gastrointestinal bleeding is a potential complication that may arise from having hiatal hernia surgery. The risk of bleeding is increased if the hernia is large and has caused an ulcer. Patients may experience blood in their stools or vomit up blood after surgery. If this occurs, it is important to seek medical attention right away as it could be a sign of a serious complication. Fortunately, most patients do not experience any bleeding complications.

Esophageal Perforation

When preparing for hiatal hernia surgery, it is important to be aware of the potential risks, such as esophageal perforation. Esophageal perforation occurs when a hole or tear is made in the esophagus. The most common cause of esophageal perforation is hiatal hernia surgery. During the procedure, the surgeon may accidentally damage the esophagus, resulting in a tear. Symptoms of esophageal perforation can include chest pain, difficulty swallowing, shortness of breath, and nausea. Prompt medical attention is necessary in the event of any of these symptoms.


When considering hiatal hernia surgery, it is important to be aware of the potential risks of infection. Infection is the most common complication following this type of surgery, and it can be a serious threat to your health. To reduce the risk of infection, your doctor will likely prescribe antibiotics before and after your surgery. It is important to take any antibiotics as prescribed to ensure that any potential infection is properly treated. In addition, it is important to practice good hygiene before and after surgery to reduce the risk of infection. By following your doctor’s instructions, you can help keep yourself safe and reduce the risk of infection after hiatal hernia surgery.

Preparing for Hiatal Hernia Surgery

Prior to hiatal hernia surgery, your doctor will recommend that you attend pre-operative appointments, during which they will review your medical history and explain the procedure. They will also explain the risks and benefits of the surgery, and provide instructions on how to prepare. Pre-surgery instructions may include fasting from food and beverages before the procedure, modifying your medications, and avoiding certain activities the day before. You will also be instructed to abstain from smoking for several weeks prior to the surgery. During these pre-operative appointments, you can ask any questions you have about the procedure and the recovery process. Knowing what to expect and being prepared can help you feel more relaxed and ready for the surgery.

Pre-Surgery Instructions

Before undergoing hiatal hernia surgery, it is important to be aware of what to expect. With this in mind, your physician will provide you with pre-surgery instructions that are essential to ensure that the procedure goes as smoothly as possible. These instructions will include what to do and avoid before and after the surgery, as well as other important information. Be sure to ask questions and make sure you understand all of the instructions provided to you. Prior to surgery, your doctor may advise you to stop taking non-essential medications and supplements, as they may interfere with the procedure. If you smoke, it is especially important to stop at least a few weeks before and after the surgery. Follow your doctor’s instructions carefully to help ensure that the surgery is a success.

Medications Prior to Surgery

It is important to discuss all medications with your doctor prior to hiatal hernia surgery. Certain medications, such as anticoagulants, nonsteroidal anti-inflammatory drugs (NSAIDs), and antibiotics may be required to reduce the risk of infection and complications. In some cases, your doctor may suggest that you stop taking certain medications a few days prior to the surgery. Make sure to follow your doctor’s instructions carefully to ensure a safe and successful outcome. Additionally, be sure to keep your doctor informed of any new medications that you plan to take or start taking leading up to your surgery.

Eating and Drinking Prior to Surgery

If you are preparing for hiatal hernia surgery, there are some important dietary and drinking considerations that you should take into account. Generally, patients are instructed to avoid eating and drinking anything for at least eight hours prior to surgery. This includes not eating food after midnight and not drinking any liquids after 4:00 am. Your doctor may provide additional specific instructions depending on your situation, so be sure to follow these guidelines carefully. It is important to note that certain medications may be taken with a very small sip of water if approved by your doctor. Once your surgery is complete, you may be allowed to consume clear liquids +/- 15 minutes after waking up. Again, it is essential to follow your doctor’s instructions in order to ensure a safe and successful surgery.

Recovering After Hiatal Hernia Surgery

Once you have undergone a hiatal hernia surgery, you will need proper time and care to recover. You can expect to experience pain, soreness, and difficulty with activities such as deep breathing, coughing and laughing. You will also likely experience some swelling in the area of the surgery, as well as fatigue.

During your recovery, it is important to rest and refrain from any strenuous activity. You should also continue to follow your doctor’s instructions for taking medications, such as pain medication, and attend any follow-up appointments. Additionally, you can help speed up your recovery by eating nutritious foods, drinking plenty of fluids, and getting plenty of rest. With proper care, you should be able to return to your normal activities within a few weeks.

Pain Management

Pain management is an important part of preparing for hiatal hernia surgery. Many people experience a significant amount of pain during and after the procedure. To help reduce the discomfort, your doctor may prescribe medications to help with pain relief. Additionally, your surgeon will provide instructions on how to care for your incision site to ensure that it heals properly. In some cases, cold compresses may be recommended to help alleviate pain and reduce swelling. Finally, your doctor may recommend physical therapy and lifestyle changes to help aid in a successful recovery. With the right preparation and care, you can make the hiatal hernia surgery process as pain-free as possible.

Activity Restrictions

Patients who are undergoing hiatal hernia surgery should be aware of certain activity restrictions they will need to follow in order to ensure the successful outcome of their surgery. During the recovery period, it is important to limit physical activities such as lifting, stooping, and bending, as this could put a strain on the hernia site. Patients typically need to restrict strenuous activities for about two weeks after surgery. Also, strenuous activities, such as vigorous exercise, should not be done for at least six weeks after surgery. Additionally, contact sports or activities that involve a lot of contact with the ground should be avoided for at least three months after hiatal hernia surgery. Following these activity restrictions will help ensure successful healing and help prevent any complications.

Dietary Considerations

When it comes to preparing for hiatal hernia surgery, dietary considerations should not be overlooked. Your doctor may advise you to make changes to your diet for the weeks leading up to and after the surgery. This may include avoiding high-fat and spicy foods, some dairy products, and carbonated beverages. Additionally, drinking plenty of water and eating smaller meals can reduce the risk of complications and help to give you a successful outcome. Your doctor can provide you with further dietary advice that is specific to your procedure.

Types of Surgery

When it comes to hiatal hernia surgery, there are several different types that can be performed depending on the size and type of hernia present. The most common type of hiatal hernia surgery is a laparoscopic hiatal hernia repair. This type of surgery is done using small incisions and special instruments to repair the hernia and can be done on an outpatient basis.

Another type of hiatal hernia surgery is a traditional open hernia repair. This type of surgery requires a larger incision and is done with the assistance of a general anesthesiologist. During this type of surgery, the surgeon will remove any affected tissue, reposition the organs, and reinforce the weakened area. The surgeon may also use a special mesh to help support the hernia repair.

Another type of hiatal hernia surgery is a minimally invasive hiatal hernia repair. This type of surgery is similar to laparoscopic hiatal hernia repair but requires a smaller incision to access the hernia. The surgeon will use special instruments and techniques to repair the hernia and may also use a special mesh to help support the hernia repair.

Finally, hiatal hernia surgery can also be done with robotic assistance. This type of surgery is done with the help of a robot that is programmed to perform the necessary surgical steps. During the surgery, the surgeon will control the robot and use it to access the hernia. The robot can be used to help with hernia repair, as well as with the placement of a special mesh to help support the hernia repair.

No matter which type of hiatal hernia surgery you undergo, it is important to be prepared for the procedure and to discuss all of your options with your surgeon. Your surgeon will be able to provide you with more information about the types of surgeries available and can help you make the best decision for your individual situation.

Laparoscopic Surgery

If your doctor recommends surgery to repair your hiatal hernia, they may suggest laparoscopic surgery. This approach is minimally invasive and can be done with just a few small incisions. During the procedure, a thin, lighted camera called a laparoscope is used to guide surgeons as they repair the hernia. Depending on the severity of your hernia, the surgeon may either secure the stomach back in place or reinforce the area with sutures or a mesh patch. Patients typically go home the same day and can resume their normal activities within two to three weeks.

Open Surgery

Open surgery, also known as open repair, is a common procedure for treating hiatal hernias. The procedure is done through a single incision in the abdomen and can be done under general or local anesthesia. During the surgery, the surgeon will make an incision near the diaphragm to access the stomach and the area of the hiatal hernia. The hernia opening is then repaired and the stomach is returned to its correct position. The surgeon may also use other techniques such as sutures or stitches to create a tighter opening. Once the surgery is complete, the incision is closed with stitches. After the surgery, it is important to follow the doctor’s instructions for recovery. This may include taking medications as directed, limiting certain activities, and changing your diet for a certain period of time.


In conclusion, hiatal hernia surgery is generally a safe and effective procedure to treat a hiatal hernia. It is important to discuss with your doctor whether this procedure is right for you and to follow their instructions closely when preparing for the surgery. Understanding the risks, preparation steps, and recovery period associated with the procedure is essential to ensure a successful procedure and a smooth recovery. While the surgery may not always be a guaranteed cure, it can be an effective way to mitigate the symptoms of a hiatal hernia and improve the quality of life for those affected.

Frequently Asked Questions

What is a hiatal hernia?

A hiatal hernia develops when part of the stomach bulges through an opening in your diaphragm (the muscle separating your chest and abdomen) into the chest cavity. This can cause severe pain, also known as epigastric or cardiac pain.

What causes a hiatal hernia? 

Hiatal hernias are usually caused by chronic strainings, such as from coughing, vomiting or lifting heavy objects. They can also be caused by eating large meals or being overweight.

What are the symptoms of a hiatal hernia?  

The most common symptoms of a hiatal hernia include:

  • Pain in your chest just below your breastbone (epigastric pain) that comes and goes or stays all day long
  • Indigestion, nausea, and vomiting
  • Heartburn

How is a hiatal hernia diagnosed? 

Your doctor can diagnose a hiatal hernia by reviewing your medical history and performing an exam.

What is the treatment for a hiatal hernia?  

A hiatal hernia can often be treated with lifestyle changes, such as losing weight and exercising regularly. If these don’t work, your doctor may recommend surgery.

Should I worry about a hiatal hernia?  

If you have symptoms that last more than four weeks, it’s important to see your doctor. In most cases, a hiatal hernia won’t cause any health problems.

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