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Hiatal Hernia Complicating Bariatric Surgery

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Difficult Decisions in Bariatric Surgery

Part of the book series: Difficult Decisions in Surgery: An Evidence-Based Approach ((DDSURGERY))

Abstract

Rates of hiatal hernia (HH) in the morbidly obese population have been reported to be as high as 37%. Increased intraabdominal pressure secondary to abdominal girth is thought to contribute to greater-than-average rates of HH in patients undergoing bariatric surgery. Additionally, while Roux-en-y gastric bypass is often considered to be an “anti-reflux” operation, the more popular surgical option, sleeve gastrectomy, is thought by many to increase the risk of unimpeded reflux. In addition to worsening of reflux symptoms after surgery, the effect of long-term acid exposure must also be considered. Consequently, controversy exists regarding the addition of concurrent hiatal repair in the setting of bariatric surgery. An additional dimension of this controversy arises when a morbidly obese patient is referred for paraesophageal hernia; the surgeon must consider whether a concurrent bariatric procedure and subsequent weight loss would result in the most durable hiatal repair. In this chapter, a diverse body of literature is reviewed and summarized, and future directions for further research and elucidation of this complex topic are explored.

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Authors and Affiliations

  1. Department of Surgery, Division of Bariatric Surgery, Oregon Health and Science University, Portland, OR, USA

    Priya Rajdev, Phylicia Dupree & Farah Husain

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  1. Priya Rajdev
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  2. Phylicia Dupree
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  3. Farah Husain
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Correspondence to Farah Husain .

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Editors and Affiliations

  1. Department of Surgery, University of Chicago, Chicago, IL, USA

    John Alverdy

  2. Department of Surgery, University of Chicago, Chicago, IL, USA

    Yalini Vigneswaran

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Rajdev, P., Dupree, P., Husain, F. (2021). Hiatal Hernia Complicating Bariatric Surgery. In: Alverdy, J., Vigneswaran, Y. (eds) Difficult Decisions in Bariatric Surgery. Difficult Decisions in Surgery: An Evidence-Based Approach. Springer, Cham. https://doi.org/10.1007/978-3-030-55329-6_27

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  • DOI: https://doi.org/10.1007/978-3-030-55329-6_27

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-55328-9

  • Online ISBN: 978-3-030-55329-6

  • eBook Packages: MedicineMedicine (R0)

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