Hiatal Hernia Post VSG
hello! I had my VSG done 3/9/2016 and all was well until about a year and a 1/2 post surgery. I developed severe herd and some abdominal pain. After a barium swallow, CT scan and an endoscopy, I was found to have a hernia and bile reflux. During the swallow my Bari surgeon also mentioned seeing a small pouch which is apparently herniating into my diaphragm underneath the breast bone. He r commended a revision to gastric bypass (I only lost 66 lbs, which I'm content with but would love to lose 15lbs more) which really scares me. My surgeon did say it would help me lose those 15 extra lbs I'd like to see gone. After 6 months of follow ups and med treatments with a GI Dr, I'm still not comfortable with the thought of a revision surgery. I see my Bari surgeon again later this week and am hoping to have him just repa R the hernia and pouch and reduce my pouch for some restriction. Has anyone had a situation similar to this or any advice?
on 4/9/18 4:44 pm
I had a hiatal hernia fixed at the time of my VSG. It didn't take and I had a second HH surgery 10 months later to fight the GERD. It's been fine ever since. Maybe a second opinion to understand all your options?
One thing to note, though, I had better restriction before the second surgery because my stomach was stuck up in my diaphragm. Once it was moved back where it should be, I don't have GERD, but I don't get full as easily either. So I wouldn't bank on future weight loss with a new surgery. For that, you have to change your eating habits for good.
I have had a abdominal hernia for a few years. It is minor and it doesn't cause any pain or discomfort but it is there. I have visited 2 different surgeons and they have not recommended surgical repair. Their recommendation instead is that I should focus on losing weight and see if how that impacts the hernia. I really don't like having it because I fear that any day it could worsen and become very painful, but they say I should not take unnecessary surgical action due to my weight.
My WLS surgeon said that when he is doing my VSG, he would look at the hernia, and if necessary he would surgically repair it. While that sounds like a fantastic "kills two birds with one stone" scenario and I hope he does repair it, it does seem a bit odd that he would be willing to do a hernia repair "on the fly" like that. Has anyone else ever heard of something like this or experienced it themselves?
on 4/10/18 8:23 am
There are different types of hernias. Hiatal hernias are where your stomach slips up through your diaphragm and can greatly increase GERD when paired with a VSG. Abdominal hernias are where parts of intestines poke out through the abdominal wall. Umbilical hernias are where parts of intestines poke out through your belly button/umbilicus. Hiatal hernias are routinely fixed during sleeve surgeries as they are already working on your stomach and it can cause long term problems if not fixed. The other types of hernias can cause other problems, but are not ruotinely fixed during sleeve surgeries. Sounds like your surgeon might work on those too and might do it while he's in there. Plastic surgeons will do that too when doing lower body lifts and tummy tucks.
on 4/10/18 1:37 pm
It's possible! Mine was stealthy. It didn't show up on the upper gi pre-vsg, but the surgeon noticed it during my vsg when his team pulled a tube out of my stomach and my stomach went with it. So they stitched it, but it broke free, he thinks when I was dry heaving in the hospital from the anesthesia. It showed up when they did an upper gi several months later when I was having trouble with reflux.
on 4/11/18 10:05 am
Just surgery, which was not bad at all. Much easier than the VSG. He stitched my esophagus to my diaphragm to keep it in place. He went in right through my previous VSG incisions, so I don't have extra scars. He did say they get worse and harder to fix over time as the stomach continuing to slide up and down stretches the hole even further, so better to take care of it sooner rather than later.
