Experiencing intermittent pain & discomfort while eating 4 yrs post gastric sleeve surgery. Had upper GI. Bariatric surgeon says my stomach is going into my esophagus due to a severe hiatal hernia. He suggests doing a revision to a gastric bypass & fixing the hernia for best results. He says just fixing the hernia may only be a temp fix with risk of reherniating a possibility down the line. I don't want a gastric bypass, but I also don't want to end of doing another surgery a few years from now.
August 19, 2017
Answer: Treatment needs to match the symptoms You describe intermittent pain and discomfort with eating. These are not the symptoms of gastroesophageal reflux. You say that your surgeon says "my stomach is going into my esophagus due to a severe hiatal hernia." That makes no sense. I assume you mis-typed, and mean that your stomach is going into your CHEST. I agree with the other surgeons that proper repair of the hernia involves mobilizing the esophagus into the chest, and making sure that, at the end of the operation, there is no tension on the repair.But all of this is "doctor stuff," and doesn't help with your decision. You need to figure out exactly what is causing your symptoms. If there really is some sort of twisting of the stomach due to the hiatal hernia, simple repair of the hernia and straightening out the stomach may solve your problem.Most patients with a sleeve stricture also complain of severe reflux. If you really have this, then conversion to gastric bypass (along with repair of the hernia) may be your best bet. But if you are dead set on not having a gastric bypass, it may be worth doing some more investigation to determine what is the exact cause of your problem. It might even be worth trying to fix the hiatal hernia and see if that helps; you can always go back later for a conversion to bypass if you don't get relief from the hiatal hernia repair.
Helpful 3 people found this helpful
August 19, 2017
Answer: Treatment needs to match the symptoms You describe intermittent pain and discomfort with eating. These are not the symptoms of gastroesophageal reflux. You say that your surgeon says "my stomach is going into my esophagus due to a severe hiatal hernia." That makes no sense. I assume you mis-typed, and mean that your stomach is going into your CHEST. I agree with the other surgeons that proper repair of the hernia involves mobilizing the esophagus into the chest, and making sure that, at the end of the operation, there is no tension on the repair.But all of this is "doctor stuff," and doesn't help with your decision. You need to figure out exactly what is causing your symptoms. If there really is some sort of twisting of the stomach due to the hiatal hernia, simple repair of the hernia and straightening out the stomach may solve your problem.Most patients with a sleeve stricture also complain of severe reflux. If you really have this, then conversion to gastric bypass (along with repair of the hernia) may be your best bet. But if you are dead set on not having a gastric bypass, it may be worth doing some more investigation to determine what is the exact cause of your problem. It might even be worth trying to fix the hiatal hernia and see if that helps; you can always go back later for a conversion to bypass if you don't get relief from the hiatal hernia repair.
Helpful 3 people found this helpful