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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 AgreementYou 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.
The week before your surgery:
- Write down the correct date, time, and location of your surgery.
- Arrange a ride home. Ask a family member or friend to drive you home after your surgery or procedure. Do not drive yourself home.
- Ask your caregiver if you need to stop using aspirin or any other prescribed or over-the-counter medicine before your procedure or surgery.
- Bring your medicine bottles or a list of your medicines when you see your caregiver. Tell your caregiver if you are allergic to any medicine. Tell your caregiver if you use any herbs, food supplements, or over-the-counter medicine.
- You may need to have a barium swallow, endoscopy, upper gastrointestinal (GI) tests, a chest x-ray, or blood tests. Talk to your caregiver about these or other tests you may need. Write down the date, time, and location for each test.
The night before your surgery:
- You may be given medicine to help you sleep.
- Ask caregivers about directions for eating and drinking.
- Bowel cleansing may be needed. You may be given medicine to drink or an enema that will empty your bowel. An enema is liquid put into your rectum.
The day of your surgery:
- Ask your caregiver before you take any medicine on the day of your surgery. Bring a list of all the medicines you take, or your pill bottles, with you to the hospital. Caregivers will check that your medicines will not interact poorly with the medicine you need for surgery.
- Caregivers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.
- An anesthesiologist will talk to you before your surgery. You may need medicine to keep you asleep or numb an area of your body during surgery. Tell caregivers if you or anyone in your family has had a problem with anesthesia in the past.
- You or a close family member will be asked to sign a legal document called a consent form. It gives caregivers permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.
What will happen:
- 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.
Contact a caregiver if
- You cannot make it to your surgery.
- You have a fever.
- You get a cold or the flu.
- You have questions or concerns about your surgery.
Seek Care Immediately if
- You have sudden, severe chest pain.
- You have trouble swallowing or breathing.
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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.