Evaluation and Surgical Treatment of Hiatal Hernias and Gastroesophageal Reflux

Kashif Irshad, Arjun Pennathur, James D. Luketich

Key Points

  • The evaluation of a patient possibly requiring surgical treatment of hiatal hernia and gastroesophageal reflux begins with a careful history.
  • Essential evaluations are barium esophagography, esophagogastroduodenoscopy with biopsy, esophageal manometry, and 24 hour pH monitoring.
  • Principles of antireflux surgery are reduction of the hiatal hernia with restoration of the intra-abdominal esophagus, repair of the esophageal hiatal mechanism, and reinforcement of the lower esophageal sphincter.
  • Choice of the operation and modification will be dictated by patient evaluation.

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Last updated: March 19, 2020