PreOp Patient Education
Tuesday, August 04, 2020

  Your Body
  Medical Record
  Before Surgery
  Your Procedure

Hernia - Hiatal

Open Repair

Your Procedure

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Now it's time to talk about the actual procedure your doctor has recommended for you.

On the day of your operation,
you will be asked to put on a surgical gown.
You may receive a sedative by mouth
and an intravenous line may be put in.
You will then be transferred to the operating table.
In the operating room, a nurse will begin preparation by clipping or shaving the abdomen.
The anesthesiologist will begin to administer anesthesia, most probably general anesthesia by injection and/or inhalation mask
The surgeon will then apply antiseptic solution to the skin ...
and place a sterile drape around the operative site.
After you're asleep,
the surgical team will make a mid line incision, from the breastbone to the navel.
Opening this incision reveals tissues that connect the abdominal muscles.
Another incision is made through these tissues ...
to allow access to the abdominal cavity.
Your surgeon will use a special oval ring to hold the incision open during the operation.
First, the surgeon gently lifts the liver up and away from the stomach. The surgical team can now see the place where the esophagus and stomach join.
Then, the surgeon cuts away the tissue that connects the liver and the stomach. This gives your doctor better access to the diaphragm and the esophagus.
Next, the surgeon pulls the esophagus upward ...
and closes the hiatus with sutures.
Your doctor may insert a rubber tube in your esophagus to keep the sutures from tightening too much around your airway.
Some hiatal hernias can cause persistent and painful acid reflux and your doctor may decide to correct the problem surgically.
In this case, the surgeon divides and separates the arteries that supply blood to the top of the stomach.
After freeing the stomach from the spleen, your doctor wraps the upper portion of the stomach around the esophagus
and sutures it into place.
A rubber tube is placed in the esophagus to keep the wrap from becoming too tight.
The special ring is withdrawn ...
the tissues that join the abdominal muscles are sewn together ...
and the skin is closed with staples.
Finally, sterile dressings are applied.

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