Hiatal Hernia - Treatment
Patients with a small sliding hiatal hernia (type I hiatal hernia) who have no symptoms, do not require any treatment and can be observed closely.
The treatment of large sliding hiatal hernia and paraesophageal hernias requires surgery to correct the anatomy, reduce the hernia and repair the opening in the diaphragm (crural opening).
Traditionally, large sliding hiatal hernias and paraesophageal hiatal hernias were repaired through a thoracotomy (incision in the chest) or laparotomy (a large incision in the abdomen) with a morbidity of 20 percent and a mortality of 2 percent.
The development of laparoscopic surgery has led to the repair of these complicated hernias by a minimally invasive approach, with five small incisions. The procedure is called laparoscopic Nissen fundoplication and is routinely performed at the Memorial Hermann.