paraesophageal hernia

I've had IBS for 10 years. Symptoms getting worse, Dr. ordered an upper GI/barium x-ray.  They found unusually large paraesophageal hernia.  Bottom of stomach, duodenum and part of bowel have flipped up and are sticking up through my diaphragm.
Dr. says I must have surgery.  Is laproscopic surgery the best for this condition?  What is the morbidity rate for this kind of surgery?  If anyone out there has undergone surgery for this kind of condition, please respond with advice.

[Kevin Pho, MD]

The surgery success rate depends on the grade of the paraesophageal hernia, which is dependent on the severity and how much of the hernia is sliding through the hiatus.  

A small study of 12 patients who underwent laparoscopic repair estimated the minor morbidity rate of 25% and a major morbidity rate of 8%.  All of the paraesophageal repairs were successful in this study and 11 of 12 patients had their pre-operative symptoms resolved.  

The study can be found here:
http://archsurg.ama-assn.org/cgi/content/abstract/130/6/590

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
Medical Weblog:
kevinmd_b

[Erik36]

I have had two repairs of a Paraesophageal hernia. Laparascopic surgery can be done to repair the hernia but it has been shown that the open procedure is usually a little more effective in the long run. The only reason I had to have my hernia repaired a second time was because I did a lot of heavy lifting and the hernia recurred. If you've never had surgery through your abdomen then it can be done with an incision from your sternum to your belly button. The pain is not that bad and it is well controlled with morphine or Demoral post surgery. I had to have the second surgery through my ribs (thoracic approach) which was the worst pain ever. You don't want to go that route. You should definitely have the surgery. The hernia could twist and become strangulated and cut off blood supply which would cause gangrene and infection and could kill you. You will be fine if you get it repaired. Make sure the surgeon anchors your organs to your abdominal wall to prevent recurrence. Best of luck!

Erik