Hiatal Hernia: Laparoscopic Repair in Netanya and Tel Aviv

In a hiatal hernia, part of the stomach moves from the abdomen into the chest through the widened opening that the esophagus passes through. Many people live with a small hernia without any complaints. Surgery is considered when the hernia causes symptoms, interferes with reflux treatment, or is large. I repair these hernias laparoscopically in Netanya and Tel Aviv.

Types of hernia

• • A sliding hernia is the most common type and often comes with reflux.
• Paraesophageal hernia: part of the stomach lies next to the esophagus; it can cause pain, vomiting, anemia and shortness of breath after meals.

Symptoms

Heartburn and belching, pain or pressure behind the breastbone after eating, a feeling of fullness, difficulty swallowing, vomiting, shortness of breath, anemia.

When surgery is needed

• Symptoms are not controlled by medication.
• Paraesophageal hernia with complaints.
• Complications: bleeding, anemia, strangulation.

I do not operate on an asymptomatic hernia.

Tests

Gastroscopy, barium swallow and CT of the abdomen; pH-impedance testing and manometry when needed.

How the operation goes

The operation is performed laparoscopically under general anesthesia. The herniated contents are returned to the abdomen, the opening in the diaphragm is repaired (reinforced with mesh when needed), and a fundoplication (Nissen, Toupet or Dor, chosen individually) is usually added to prevent reflux.

Recovery

You usually stay one to two days in hospital. Eating starts with liquids and is advanced gradually; in the first weeks, difficulty swallowing, bloating and inability to belch are possible. You keep taking a PPI for the first month, and the follow-up is after one month. Return to work and sports follows the usual timeline after laparoscopic surgery.

Risks

Difficulty swallowing, bloating, return of the hernia or reflux, and complications of anesthesia and of the operation itself. I discuss them with you in detail before surgery.

Where and how it is covered

Surgery is performed at Laniado Hospital (public healthcare) and at the private hospitals Assuta, Herzliya Medical Center and Raphael. Coverage depends on your health fund and insurance. I work with Maccabi, Leumit (Shaban), Clalit (Mushlam), Menora, Ayalon and Clal. Patients with other insurers are welcome for a consultation; I operate only under policies unchanged since 2016.

FAQ

Should a small hernia be operated on?
Not if it causes no symptoms or problems. I do not operate on an asymptomatic hernia.

How is a hiatal hernia different from GERD?
GERD is the backflow of stomach contents into the esophagus, while a hernia is an anatomical defect. They often occur together, but not always.

Can the hernia come back?
Yes, recurrence is possible. It depends on the size of the hernia and on technique. I do not quote numbers.

Can medication be enough?
Medication reduces acidity and symptoms but does not correct the hernia itself.

See also

GERD and reflux · Bariatric surgery · About me