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Minimally Invasive Esophagectomy

Patients with Benign Esophageal Diseases

I have benign esophageal disease. What are my treatment options?

The goals of benign esophageal disease treatment are to relieve symptoms and prevent complications. Reducing the backflow of stomach contents into the esophagus (gastroesophageal reflux) will relieve pain. Medications that neutralize stomach acid, decrease acid production, or strengthen the lower esophageal sphincter (the muscle that prevents acid from backing up into the esophagus) may be prescribed.

There are other measures to reduce symptoms including: avoiding large or heavy meals, not lying down or bending over right after a meal, reducing weight and not smoking.

If these measures do not control the symptoms, or you have complications, you may need surgery to repair the hernia (see hiatal hernia Q&A below).

I have been scheduled for a hiatal hernia repair. What does the operation entail?

When the opening (hiatus) in the muscle between the abdomen and chest (diaphragm) is too large, some of the stomach can slip up into the chest cavity. This can cause heartburn (gastro-esophageal reflux: GER) as gastric acid backflows from the stomach into the esophagus. Hiatal hernia repair is surgery to repair a bulging of stomach tissue through the muscle between the abdomen and chest (diaphragm) into the chest (hiatal hernia).

Hiatal hernia repair may be recommended when the patient has:

  • severe heartburn
  • severe inflammation of the esophagus from the backflow of gastric fluid (reflux)
  • narrowing of the opening (hiatus) through the diaphragm (esophageal stricture)
  • chronic inflammation of the lungs (pneumonia) from frequent breathing in (aspiration) of gastric fluids

While the patient is deep asleep and pain-free (general anesthesia), an incision is made in the abdomen.

The stomach and lower esophagus are placed back into the abdominal cavity. The opening in the diaphragm (hiatus) is tightened and the stomach is stitched in position to prevent reflux. The upper part of the stomach (fundus) may be wrapped around the esophagus (fundoplication) to reduce reflux.

How long will I stay in the hospital?

Patients may need to spend three to 10 days in the hospital after surgery. A tube will be placed into the stomach through the nose and throat (nasogastric tube) during surgery and may remain for a few days. Small, frequent feedings are recommended.