Laparoscopic Hiatal (Hiatus) Hernia Repair & Fundoplication

Procedure time: 60–180 minutes • Hospital stay: 1–3 nights • Recovery: 4–8 weeks depending on repair

What is it?

Hiatal hernia repair corrects anatomic displacement of the stomach through the diaphragm (hiatus). When combined with fundoplication, the top of the stomach is wrapped around the lower esophagus to strengthen the anti-reflux barrier and reduce GERD symptoms.

Who is a candidate?

• Patients with symptomatic GERD not controlled with medication.
• Individuals with large sliding or paraesophageal hernias causing pain, dysphagia, aspiration or anaemia from reflux-related oesophagitis.
• Patients fit for general anaesthesia after standard pre-op assessment.

When should you choose surgical repair?

Surgery is recommended for large paraesophageal hernias, refractory reflux despite optimal medical therapy, recurrent aspiration, or when quality of life is significantly affected by symptoms.

Comparison with alternatives

• Medical therapy (PPI) manages acid but does not correct the anatomical hernia—surgery treats the root cause.
• Endoscopic therapies are limited for anatomical hernia repair and select reflux cases; most anatomical defects need surgical correction.

Pre-op preparation & tests

• Upper endoscopy, barium swallow and oesophageal manometry/pH testing as indicated.
• Blood tests, ECG, anaesthetic assessment and optimization of comorbidities.
• Smoking cessation and pre-op instruction for fasting and medications.

Day of surgery — what to expect

Performed under general anaesthesia with laparoscopy. The stomach is reduced into the abdomen, the hiatus is repaired (sutures or mesh if needed) and fundoplication (partial or complete) performed when indicated. Post-op monitoring and early mobilisation are standard.

How surgery is done

Laparoscopic reduction of hernia sac → repair/closure of diaphragmatic crura → (optional) reinforcement with mesh → fundoplication (Nissen, Toupet or partial wrap based on physiology).

Benefits

• Long-term control of reflux symptoms and decreased dependence on PPIs for many patients.
• Prevention of complications from paraesophageal hernia such as strangulation or obstruction.
• Minimal scarring and faster recovery than open repair.

Expected recovery & timeline

• Immediate: hospital observation 1–3 days depending on complexity.
• 2–6 weeks: gradual return to normal diet and activities; temporary dysphagia and gas bloating may occur and usually improve.
• 6–12 weeks: most patients resume full activity; long-term follow-up for persistent reflux or dysphagia.

Post-op instructions

• Soft diet advancing to normal as tolerated; avoid heavy lifting and Valsalva for 6 weeks.
• Report severe dysphagia, fever, persistent vomiting or chest pain immediately.
• Attend scheduled follow-ups and investigations if symptoms persist.

Tourmedx packages

We coordinate specialist surgeons, pre-op tests, VIP transfers, translation, recovery hotels and virtual follow-up. Request a personalised package and surgical plan.