A hiatal hernia repair is a specialized surgical procedure that addresses the protrusion of the stomach through the diaphragm into the chest cavity. At our practice, we understand that hiatal hernias can cause significant discomfort and health concerns when they become symptomatic or large. That's why we're committed to providing compassionate, expert care while helping you understand each stage of your treatment.
This targeted procedure effectively treats various types of hiatal hernias, including sliding hernias (where the gastroesophageal junction moves above the diaphragm) and paraesophageal hernias (where part of the stomach herniates alongside the esophagus), which can cause reflux, chest pain, breathing difficulties, and even dangerous complications like strangulation.
At Lifetime Surgical, our hiatal hernia repair approach utilizes advanced laparoscopic techniques to return the stomach to its proper position below the diaphragm, repair the weakened diaphragmatic opening, and often includes an anti-reflux procedure when necessary. We employ specialized mesh reinforcement in select cases and precise suturing techniques that provide durable results with minimal recovery time for significant improvement in both symptoms and quality of life.
You may need hiatal hernia repair if you experience:
Persistent heartburn or acid reflux despite medication
Regurgitation of food, especially when lying down
Chest pain or pressure that mimics cardiac symptoms
Difficulty swallowing (dysphagia) or feeling that food gets stuck
Shortness of breath, especially after eating
Chronic cough, hoarseness, or asthma-like symptoms
Paraesophageal hernia identified in imaging studies
Large hiatal hernia (greater than 5 cm)
Anemia from bleeding at the hernia site
Vomiting or retching from stomach obstruction
Early satiety and inability to eat normal portions
Frequent belching or hiccups
Iron deficiency anemia from Cameron ulcers within the hernia
Aspiration pneumonia from refluxed contents
Our approach to hiatal hernia repair combines precision with personalized care. The procedure begins with a comprehensive preoperative evaluation, including endoscopy, contrast studies, and sometimes CT imaging to fully characterize the hernia's size, type, and associated complications. Our surgeon has vast expertise in minimally invasive techniques, using 4-5 small laparoscopic incisions to access and repair even large and complex hernias with excellent visualization and minimal post-operative discomfort. During surgery, we meticulously reduce the hernia contents, returning the stomach to its proper position below the diaphragm, while carefully preserving surrounding structures including the vagus nerves.
Our distinctive approach includes precise closure of the diaphragmatic defect using non-absorbable sutures in a tension-free manner, with selective use of biologic or synthetic mesh reinforcement for larger defects to minimize recurrence risk. For patients with reflux symptoms, we frequently incorporate a tailored anti-reflux procedure such as a Nissen, Toupet, or Dor fundoplication, customized to your specific anatomy and symptoms.
Throughout your care journey, we implement enhanced recovery protocols specific to hiatal surgery, incorporating optimal pain management, early mobility, and carefully planned dietary progression. Our multidisciplinary team includes dedicated gastroenterologists and nutritionists who provide specialized guidance through your recovery, ensuring not only expert surgical repair but comprehensive care that addresses all aspects of your condition for optimal long-term outcomes.
Immediate Post-Procedure (1-3 days)
Expect a hospital stay of 1-3 days depending on the complexity of your repair
Begin with clear liquids, advancing to full liquids before discharge
Experience some shoulder pain from CO2 gas used during laparoscopy
Use multimodal pain management approaches to control discomfort
Walk frequently to help dissipate gas pain and prevent respiratory complications
Practice incentive spirometry to expand your lungs fully
Avoid straining, vomiting, or forceful coughing which could stress the repair
Learn proper techniques for standing, sitting, and sleeping with your head elevated
Receive specific dietary instructions, especially if an anti-reflux procedure was included
Prepare for discharge with a clear understanding of activity restrictions and warning signs
Short-Term Recovery (1-4 weeks)
Attend your follow-up appointment (typically 7-10 days after surgery)
Progress through dietary stages as directed, typically starting with liquids and soft foods
Take small, frequent meals rather than large portions
Avoid lifting anything heavier than 10-15 pounds for 4-6 weeks
Return to work based on your surgeon's recommendation and job requirements (typically 1-2 weeks)
Continue walking daily, gradually increasing distance as comfort allows
Expect some initial swelling around the repair site that may cause temporary swallowing adjustments
Monitor for proper wound healing and report any concerns
Experience noticeable improvement in pre-operative symptoms
Avoid carbonated beverages that can cause bloating
Sleep with the head of your bed elevated (6 inches) to reduce pressure on the repair
Long-Term Adjustment (1-3 months)
Continue expanding your diet to include more normal textures and foods
Return to full physical activities, including exercise, after 6-8 weeks
Notice improved breathing, especially when lying down
Experience continued resolution of reflux-related symptoms if present pre-operatively
Follow your surgeon's recommendations regarding anti-reflux medication adjustments
Notice progressive ease of swallowing as the initial swelling resolves completely
Develop awareness of activities that increase abdominal pressure and use proper techniques
Begin core-strengthening exercises when approved by your surgeon
Establish eating habits that promote successful long-term outcomes
Maintain a healthy weight to reduce pressure on the diaphragmatic repair
Follow up with your gastroenterologist regarding any previous esophageal changes
Long-Term Expectations
Complete internal healing occurs within 3-4 months
Minimal procedurDiscreet access points that fade considerably within 6-12 monthse traces that become increasingly subtle over time
Significant reduction or elimination of pre-operative symptoms for most patients
Reduced risk of hernia-related complications like strangulation or volvulus
Improved respiratory function without diaphragmatic compression
Resolution of regurgitation and associated symptoms
Better tolerance for meals without early satiety
Most patients report high satisfaction and improved quality of life
Potential for recurrence is 5-10% for standard repairs, higher for very large hernias
If an anti-reflux procedure was performed, potential for related side effects such as gas bloating
Annual check-ups help ensure continued hernia control
Long-term success depends on avoiding excessive abdominal pressure from heavy lifting, straining, or significant weight gain
Common Side Effects
Long-term success depends on avoiding excessive abdominal pressure from heavy lifting, straining, or significant weight gain
Mild bloating sensation or gas discomfort
Transient altered sensation near the small incisions
Early satiety (feeling full quickly) during initial adjustment
Mild shoulder pain from residual CO2 gas
Need for dietary modifications initially
Temporary chest or upper abdominal discomfort during healing
Minor bruising around laparoscopic port sites
Less Common Complications
Recurrence of the hiatal hernia (5-15% depending on size and type)
Persistent dysphagia (difficulty swallowing) requiring intervention
Damage to the vagus nerve affecting stomach emptying
Esophageal or gastric injury requiring repair
Surgical site infection (rare with laparoscopic approach)
Mesh-related complications if mesh was used
Small bowel obstruction due to adhesions
Persistent gas bloat syndrome if fundoplication was performed
Splenic injury requiring repair or removal (very rare)
Diaphragmatic injury beyond the hernia repair
Perforation of the esophagus or stomach (rare)
Incisional hernia at port sites
When to Seek Immediate Medical Attention
Fever over 101°F (38.3°C)
Severe, worsening chest or abdominal pain
Persistent nausea or vomiting
Complete inability to swallow liquids or solids
Shortness of breath or difficulty breathing
Significant abdominal distension or bloating
Significant redness, warmth, swelling, or drainage at incision sites
Reopening of any surgical wound
Persistent hiccups lasting more than 48 hours
Severe shoulder pain not relieved by walking or pain medication
Signs of dehydration due to inadequate liquid intake
Symptoms similar to your pre-operative hernia symptoms
From your first consultation through your complete recovery, we provide:
Thorough evaluation and explanation of your condition
Clear discussion of all treatment options, including non-surgical alternatives when appropriate
Detailed pre-operative instructions to help you prepare
Compassionate care during your hospital stay or outpatient procedure
Comprehensive follow-up care and support during recovery
Ongoing availability to address questions or concerns
We understand that facing head and neck surgery can be intimidating, but you don't have to navigate this journey alone. Our team is committed to providing expert care with a personal touch, ensuring you feel supported, informed, and confident every step of the way.
Your health and wellbeing are our highest priorities, and we're honored to be part of your care team.
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All our laparoscopic procedures are performed by our highly trained surgical team using state-of-the-art equipment and techniques.
We're committed to providing you with the most advanced, minimally invasive options because we believe you deserve:
Less pain after surgery
Shorter hospital stays
Faster return to work and activities you enjoy
Smaller, less visible scars
Lower risk of complications
Better overall outcomes
Dr. Richard Nguyen is a board-certified General Surgeon with over 20 years of surgical expertise and fellowship training in Minimally Invasive and Bariatric Surgery from Vanderbilt University. Since establishing his practice in San Jose in 2007, he has pioneered innovative surgical techniques, including single-incision laparoscopic procedures and mastery of the da Vinci Robotic Surgical System. Beyond his acclaimed bariatric surgery practice, he has earned national recognition for his specialized expertise in both non-mesh and advanced mesh hernia repairs, while also serving as a critical approach surgeon for anterior spine access procedures. Dr. Nguyen combines technical precision with personalized care across multiple premier facilities throughout the South Bay Area.
I would refer Doctor Nguyen to anyone, in fact I have and they have all had the same experience as me. He is truly great. I owe all my success to Doctor Nguyen and I thank him for all the work he has done for me and continues to do so. He is extremely amazing, and I am very grateful to him.
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At 50, I now have a life I had only dreamed of a year before. My body tells me if I am done eating. This surgery is a tool that I have used to the fullest. It is not an easy way out. It still took work. But I honestly know that I would not be living this amazing new life if I didn’t step forward to embrace this life-saving surgery.
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Dr. Nguyen has changed my life completely. I feel so much better and I also feel like I’ve got control of my life again…I had high blood pressure, diabetes and cholesterol. I took at least 5 different medications for the past 30 years. NOW, after surgery I take no medications only vitamins!
Wondering which surgical procedure might be right for your condition? We're here to help you understand your treatment options and develop a personalized surgical plan. Contact our office today to schedule a consultation.
Your path to improved health may be more achievable than you think—with advanced surgical techniques leading to faster recovery, reduced complications, and a significantly enhanced quality of life.