Esophagus and Stomach Surgery
Laparoscopic Paraesophageal Hernia Repair
A paraesophageal hernia is a type of hiatus hernia. A hiatus hernia is classified by the protrusion of the upper stomach into the thorax, due to a weakness or tear in the diaphragm. A paraesophagael hernia occurs when the stomach extends out and lies next to the esophagus. While this type of hernia is rare, it is also difficult to diagnose, as it may only cause generic symptoms such as heart palpitations, chest pain and shortness of breath.
Dietary changes can sometimes help relieve symptoms, including avoiding foods high in acid that may aggravate the hernia. For those whose symptoms are severe, surgery may be necessary. The surgeons at Mount Sinai have great experience in repairing paraesophageal hernias using laparoscopic techniques.
Laparoscopic Nissen Fundoplication (anti-reflux surgery)
Gastrointestinal Reflux Disease (GERD) occurs when the band of muscle around the lower esophagus fails to tighten after eating or drinking, which then allows stomach acid to move upward and back into the esophagus.
You may be a candidate for anti-reflux surgery if:
- Medication fails to improve your symptoms
- You need treatment for the rest of your life
- You are unable to take regular medication
- You have complications such as difficulty swallowing.
The surgeons at Mount Sinai complete a thorough evaluation for each patient to assess the level of damage that the reflux has caused and to ensure that that your condition will be improved by surgery.
At Mount Sinai, laparoscopic nissen fundoplication is a frequently performed anti-reflux surgery. Using laparoscopic techniques, our surgeons wrap the top of the stomach around the outside of the lower esophagus to tighten the lower esophageal sphincter.
The benefits of laparoscopic nissen fundoplication include less blood loss, minimal scarring, and decreased chance of infection, shorter hospital stays and recovery times. Most people who undergo this procedure are able to leave the hospital the next day and are able to resume their activities after a relatively short amount of time.
Laparoscopic Heller Myotomy
Achalasia is a rare condition of the esophagus that is caused by the failure of the nerves that control the esophageal muscles, making it difficult to swallow. Although there is no cure, there are many treatments available to alleviate symptoms for years at a time. The surgeons at Mount Sinai can treat achalasia through a procedure called laparoscopic Heller myotomy, which is the most permanent solution available.
Laparoscopic heller myotopy is a procedure in which the esophageal sphincter muscle is cut (esophagomyotomy), allowing the muscle to relax. The success rate of this procedure is about 90 percent, with few patients who need to have a second surgery.
In many cases, patients who undergo a laparoscopic heller myotomy develop GERD afterwards. To prevent GERD, the surgeons at Mount Sinai may perform nissen fundoplication (a procedure to wrap the upper stomach around the lower esophagus) during the same operation to prevent reflux.
The benefits of laparoscopic heller myotomy include less blood loss, minimal scarring, decreased chance of infection, shorter hospital stays and recovery times. Most people who undergo this procedure are able to leave the hospital the next day and are able to resume their activities after a relatively short amount of time.
The Aufses Division of General Surgery
5 East 98th Street, 14th Floor
New York, NY 10029