Hiatal hernia repair after DS

[Kristaz]

Has anyone had hiatal hernia repair after DS? Have had reflux for years, take a zegrid daily and been fine. It is getting WORSE, regurgitation, acid, waking up choking. (Also gaining weight) Called DrK… sent me for GI. Radiologist reports reflux and large hiatal hernia. Waiting to hear back from Dr K.

 

[RainCity]

Dr K repaired my hiatal hernia in 2018 after gastric bypass in 2017. I had severe GERD pre-WLS and am doing so much better now. He also did a Nissen fundoplication and removed my LINX device during the hernia repair surgery.

 

[Kristaz]

Dr K repaired my hiatal hernia in 2018 after gastric bypass in 2017. I had severe GERD pre-WLS and am doing so much better now. He also did a Nissen fundoplication and removed my LINX device during the hernia repair surgery.

Yeah, he revised me from a RNY to DS about 5 years ago. I now have a hiatal hernia.

 

[Justme222]

Has anyone had hiatal hernia repair after DS? Have had reflux for years, take a zegrid daily and been fine. It is getting WORSE, regurgitation, acid, waking up choking. (Also gaining weight) Called DrK… sent me for GI. Radiologist reports reflux and large hiatal hernia. Waiting to hear back from Dr K.

Did you have the hernia when you got the DS? I had a good size HH when I got my surgery, and my surgeon did the repair at the same time. I felt the recovery was worse because it was harder to swallow enough fluids after the HH repair, but I was happy to only go under one time.

 

[Justme222]

If you didn't have the HH when you had your surgery how would you have developed one after DS surgery? I thought the HH was from overeating in general which you have a hard time doing after DS.

 

[Kristaz]

If you didn't have the HH when you had your surgery how would you have developed one after DS surgery? I thought the HH was from overeating in general which you have a hard time doing after DS.

Not sure. I have had reflux pretty badly since surgery. I don’t recall Dr K mentioning it and would have thought he’d repair at the time. However I will say I’ve always felt I had very little restriction. And never got to goal weight. I was a revision from RNY to DS for dumping and considered a lightweight

 

[Kristaz]

Did you have the hernia when you got the DS? I had a good size HH when I got my surgery, and my surgeon did the repair at the same time. I felt the recovery was worse because it was harder to swallow enough fluids after the HH repair, but I was happy to only go under one time.

Not that I’m aware of Dr K did my revision from RNY to DS he’s pretty thorough so I would’ve assumed he would’ve caught it at that time and mentioned it but I don’t know for sure to be honest.

 

[southernlady]

If you didn't have the HH when you had your surgery how would you have developed one after DS surgery? I thought the HH was from overeating in general which you have a hard time doing after DS.

No clue but I’ve developed one 10 years post DS. Still very small.

 

[Georgepds]

Common after the VSG... see

Hiatal hernia after sleeve gastrectomy | Radiology Case | Radiopaedia.org

Sleeve gastrectomy (SG) is a frequent surgical procedure for the treatment of morbid obesity. De novo hiatal hernia of the gastric tube can occur as a complication. The suggested mechanisms responsible for the development of a hiatal hernia afte...

radiopaedia.org

"The suggested mechanisms responsible for the development of a hiatal hernia after sleeve gastrectomy are:

Dissection of hiatal ligaments (phrenogastric and phreno-oesophagal ligaments during the creation of the gastric tube)

tubular shape of the gastric sleeve and the difficulty in anchoring the sleeve to the surrounding structures

rapid weight loss following the SG may lead to enlargement of the hiatal orifice


regaining of body weight and the dilatation of the whole gastric tube might also be a factor because of the increase in intragastric pressure"

 

[JackieOnLine]

I'll bet I have one, again. I know my VSG surgeon fixed the one I had then.

 

[southernlady]

rapid weight loss following the SG may lead to enlargement of the hiatal orifice


regaining of body weight and the dilatation of the whole gastric tube might also be a factor because of the increase in intragastric pressure"

Mine didn’t appear til 10 years out, well after my rapid loss period.
And I sure as hell haven’t regained anything.

 

[Justme222]

Good luck if you have to have surgery. Sorry for all the questions I'm just trying to understand and learn what causes it. I didn't even know I had one when I had my DS and HH repair. Now it looks like it can reoccur. Oh yeah! Lol
I can't tell you how bad the repair was because it was same time as DS, but Dr. Did say mine was pretty big.

 

[Georgepds]

.... Now it looks like it can reoccur. Oh yeah! Lol..

More common than I thought... but take the incidence with caution.. the base patient population here , I think, had. gerd

Incidence of de Novo Hiatal Hernia after Laparoscopic Sleeve Gastrectomy - Obesity Surgery

Purpose After laparoscopic sleeve gastrectomy (LSG), several studies have reported an increase in the incidence of gastroesophageal reflux (GERD). The etiopathogenesis of GERD post-LSG is multifactorial, and hiatal hernia (HH) is one of them. The primary objective was to measure the incidence of...

link.springer.com

"According to the data of LSG, with a follow-up of < 18 months, 60% presented HH; meanwhile, with a follow-up of > 18 months, 84.6% presented HH (p = 0.02)."

 

[Georgepds]

For those, like me, who said "say wha" to this clause

"Dissection of hiatal ligaments (phrenogastric and phreno-oesophagal ligaments during the creation of the gastric tube)"

One ligament connects the stomach to the esophagus, the other connects the stomach to the body wall. These are dissected during VSG, and the alterations can lead to HH later

Some pics

 

[aaa]

No clue but I’ve developed one 10 years post DS. Still very small.

Me, too.