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Laparoscopic Paraesophageal Hernia Repair
WHAT YOU SHOULD KNOW:
- A laparoscopic (LAP-ah-ro-skop-ik) paraesophageal (PAR-ah-e-sof-ah-je-al) hernia (PEH) repair is a surgery to correct a defect in the diaphragm. The defect is from an opening in the diaphragm causing the stomach to herniate (bulge) upward into the chest. Normally, the esophagus (food pipe) goes through a hiatus (small opening) in the diaphragm. The diaphragm is a muscular wall that separates your chest and abdomen (stomach). With PEH, the hiatus in the diaphragm is too large or the muscles around the hiatus are weak. A large opening may allow a sac to squeeze through and position next to the esophagus. This herniated sac may contain a part of the stomach and peritoneum (abdominal lining). As the herniated sac gets trapped in the chest, it causes stomach acid to back up into the esophagus and damage the esophagus.
- In a laparoscopic PEH repair, small incisions (cuts) are made in your abdomen. Caregivers will insert special tools and a laparoscope through these incisions to do the surgery. A laparoscope is a long metal tube with a light and tiny video camera on the end. This gives caregivers a clear view of the abdominal area while watching the images on a monitor. During this surgery, your stomach will be pulled back down and stitched to your abdomen. The opening in your diaphragm will be made smaller using stitches or by adding a patch. Your caregiver may also repair the muscles of your esophagus if they are weak. With a laparoscopic PEH repair, the symptoms of the hernia may be relieved and damage to your esophagus prevented.
- Keep a current list of your medicines: Include the amounts, and when, how, and why you take them. Take the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency. Throw away old medicine lists. Use vitamins, herbs, or food supplements only as directed.
- Take your medicine as directed: Call your primary healthcare provider if you think your medicine is not working as expected. Tell him about any medicine allergies, and if you want to quit taking or change your medicine.
- Antibiotics: This medicine is given to fight or prevent an infection caused by bacteria. Always take your antibiotics exactly as ordered by your primary healthcare provider. Do not stop taking your medicine unless directed by your primary healthcare provider. Never save antibiotics or take leftover antibiotics that were given to you for another illness.
- Pain medicine: You may need medicine to take away or decrease pain.
- Learn how to take your medicine. Ask what medicine and how much you should take. Be sure you know how, when, and how often to take it.
- Do not wait until the pain is severe before you take your medicine. Tell caregivers if your pain does not decrease.
- Pain medicine can make you dizzy or sleepy. Prevent falls by calling someone when you get out of bed or if you need help.
Ask for information about where and when to go for follow-up visits:
For continuing care, treatments, or home services, ask for more information.
Do not drink alcohol:
Some people should not drink alcohol. These people include those with certain medical conditions or who take medicine that interacts with alcohol. Alcohol includes beer, wine, and liquor. Tell your caregiver if you drink alcohol. Ask him to help you stop drinking.
As you recover from surgery, you may be given soft foods to eat or thickened liquids to drink. You may be placed on a full diet as your swallowing gets better. A caregiver, called a dietitian, may talk to you about your feeding and nutrition. A swallowing therapist may also help if you continue to have trouble swallowing. This person has special training to help people learn safer ways to swallow. The swallowing therapist will also help you learn which foods and liquids are safe to eat and drink.
Do not smoke:
If you smoke, it is never too late to quit. Ask for information about how to stop smoking if you need help.
When you are allowed to bathe or shower, carefully wash the incisions with soap and water. Afterwards, put on clean, new bandages. Change your bandages any time they get wet or dirty. Ask your caregivers for more information about wound care.
CONTACT A CAREGIVER IF:
- You have a fever.
- You have chills, a cough, or feel weak and achy.
- You have nausea (upset stomach) or vomiting (throwing up).
- Your bandage becomes soaked with blood.
- Your skin is itchy, swollen, or has a rash.
- You have chest pain or trouble breathing that is getting worse over time.
- You have questions or concerns about your surgery, condition, or care.
SEEK CARE IMMEDIATELY IF:
- You feel so full and cannot burp or vomit (throw up).
- You have pus or a foul-smelling odor coming from your incision.
- You have trouble swallowing.
- Your bowel movements are black, bloody, or tarry-looking.
- Your vomit looks like coffee grounds or has blood in it.
- You suddenly feel lightheaded and have trouble breathing.
- You have new and sudden chest pain. You may have more pain when you take deep breaths or cough. You may cough up blood.
- Your arm or leg feels warm, tender, and painful. It may look swollen and red.
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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.