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Laparoscopic Paraesophageal Hernia Repair
WHAT YOU SHOULD KNOW:
A laparoscopic paraesophageal hernia (PEH) repair is surgery to repair a hiatal hernia.
CARE AGREEMENT:You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.
- Problems may happen during your laparoscopic PEH repair that may lead to a laparotomy (open surgery). Your esophagus, stomach, blood vessels, or nerves may get injured during the surgery. You may bleed more than expected or get an infection. Even after you have this surgery, there is a chance that you could have another paraesophageal hernia. You may get a blood clot in your leg or arm. This may become life-threatening.
- Without treatment, the hernia may slide into your chest, get trapped, and not slide back into your abdomen. If this happens, the tissue of the trapped stomach may die if its blood supply is cut off. You may also have sudden severe chest pain and problems swallowing. This may lead to other serious medical problems.
WHILE YOU ARE HERE:
Before your surgery:
- Informed consent is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.
- An IV is a small tube placed in your vein that is used to give you medicine or liquids.
- General anesthesia will keep you asleep and free from pain during surgery. Anesthesia may be given through your IV. You may instead breathe it in through a mask or a tube placed down your throat. The tube may cause you to have a sore throat when you wake up.
During your surgery:
- Your surgeon will make a small incision above your belly button. He will insert a laparoscope through this incision. A laparoscope is a long metal tube with a light and camera on the end. Your surgeon will insert other instruments by making 2 to 4 smaller incisions at different places on your abdomen. Tools are used to remove the sac that contains your herniated stomach.
- Your stomach will then be placed back into its normal position. Stitches or mesh may be placed to close or decrease the size of your enlarged hiatus (opening in the diaphragm). Your caregiver may wrap a portion of your stomach around the esophagus. Your stomach will then be stitched and attached to the abdominal wall. The incisions will be closed with stitches or surgical tape and covered with bandages.
After your surgery:
You will be taken to a room to rest until you are fully awake. Caregivers will monitor you closely for any problems. Do not get out of bed until your caregiver says it is okay. When your caregiver sees that you are okay, you will be able to go home or be taken to your hospital room. The bandages used to cover your stitches keep the area clean and dry to prevent infection. A caregiver may remove the bandages soon after your surgery to check your abdominal area.
- You may need to walk around the same day of surgery, or the day after. Movement will help prevent blood clots. You may also be given exercises to do in bed. Do not get out of bed on your own until your caregiver says you can. Talk to caregivers before you get up the first time. They may need to help you stand up safely. When you are able to get up on your own, sit or lie down right away if you feel weak or dizzy. Then press the call light button to let caregivers know you need help.
- You will be able to drink liquids and eat certain foods once your stomach function returns. You may be given ice chips at first. Then you will get liquids such as water, broth, juice, and clear soft drinks. If your stomach does not become upset, you may then be given soft foods, such as ice cream and applesauce. Once you can eat soft foods easily, you may slowly begin to eat solid foods.
- You may need to wear pressure stockings or inflatable boots. The stockings are tight and put pressure on your legs. The boots have an air pump that tightens and loosens different areas of the boots. Both of these improve blood flow and help prevent clots.
- An esophagram is an x-ray of your esophagus and stomach. You may be given a liquid to drink to help your esophagus and stomach show up better on the x-rays. An esophagram can show if there is a leakage or blockage on the repaired area of your paraesophageal hernia. Follow the instructions from your caregiver before and after the test.
- Antibiotics help prevent infection caused by bacteria.
- Antinausea medicine helps calm your stomach and prevents vomiting.
- Pain medicine may be given. Do not wait until the pain is severe before you ask for more medicine.
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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.