Hiatal Hernia, Considering DS

Hello. Dr. Zare was not very helpful. He requested I take a food allergy test (I did set one up) and to speak to a nutritionalist (sure, will reach out to one for tips on a healthy vegetarian diet until I can eat meats again) about losing the excess weight. I don't think he fully understood me and my situation, and made the assumption that I just eat poorly and put on Covid weight. My regular doctor and other doctors who have been treating my recent ulcers and such disagree, and I was able to connect with my original surgeon, Dr. Jossart, and have a consult with him next week. So no real answers yet, just extremely varying opinions on what is, or is not, feasible.

Another update. Spoke with my original surgeon, Dr. Jossart, and he agreed to repair my hernia, without needing to convert to anything. :) Dr. Zare was the only person who was on an extreme opinion, while several other doctors agreed that there have been plenty of diagnostic tests to show there is a physical concern. I go in next week for the repair and hoping for better days ahead. :)

I am so sorry that you are facing this problem, but I am glad you posted because I have been having symptoms that I am pretty sure are from a hiatal hernia. I've been reading up trying to figure out if it's possible to fix this without resorting to doing an RNY.

Do you mind if I ask, did Dr. Jossart tell you anything about the success rate for a post-VSG hiatal hernia repair? Did he tell you anything about why so many people advise another bariatric procedure to fix this and why he doesn't? I am asking just because it seems really hard to find much info about dealing with a hiatal hernia after VSG except to just convert to an RNY. I absolutely do not want an RNY and I am afraid that I am going to be told it is the only option to fix this.

Hi, Miss Kay,

I almost never come here anymore but just popped on because of this very issue so thought i would reply as I recently consulted Dr. Jossart about my hiatal hernia/reflux/gerd. I had my sleeve surgery a long time ago....coming up on 14 years this summer, wow! Dr. Jossart did my original sleeve surgery. I developed a hiatal hernia after that. He performed a laparascopic surgery to repair it about a year after my sleeve, but, to be honest, it didn't really ever give me any relief, and I just lived with it. A few years passed. Dr. Jossart left LapSF and my GERD got worse, so I consulted Dr. Paul Cirangle, who was Dr. Jossart's former partner, still at Lap SF. He performed a 2nd surgery to repair what was a large hiatal hernia and used a biologic mesh. This repair worked VERY well...for a while...but after a few more years, it recurred. I have just been living with it, but I need to take a double dose of a PPI...I have borderline osteoporosis (which was the cause of my mother's death and my younger sister has it as well)...so it's obviously a concern. Finally I decided to go back to Dr. Jossart. I should say that Dr. Cirangle had told me that if the GERD recurred, I would have to convert to the RnY, and that was what I was expecting Dr. J to say. But he won't (or almost never) convert to RnY because he believes it is such a flawed surgery. He felt that even taking a double dose of PPIs and living with GERD is a lesser health risk than converting to RnY. He also told me that he knows of other sleeve patients who have had 3 surgical repairs of hernias and the 3rd one finally worked...but I am just really at the beginning of looking at options with him. I had had some regain which he wanted me to lose before we discussed things further, and I have done that, so I am reopening the conversation with him. Not at all sure what to do, especially since the first time he tried to fix the hernia, it was not at all successful. But I know of other people who have had them repaired quite successfully post VSG. I just seem to have a weak wall and/or a weak esophageal sphincter. Anyway, I hope that answers your question. There are DEFINITELY options other than RnY and I am an outlier--I think most of the repairs are pretty successful.

Lizanne

Hello everyone,

I'm so sorry to hear of additional complications with hiatal hernias post VSG, but I suppose this means - we are not alone. Dr. Jossart repaired my hernia on March 2nd. I'm 3 weeks out, and for the first time in a year, ate some chicken last night and did not get sick! I'm still mending, and I'm also reminded by Dr. Jossart and personal experience as I'm recovering to chew super thoroughly and take small bites, eating slowly. This is supposed to help with recovery, but also reduce the reoccurrence of the hernia. Once a hiatal hernia problem, the potential is great for having it again. Something like 15% from what I've read? I forgot what number Dr. Jossart gave me. However, I am hopeful this worked. Although he left the previous hospital group, he is working under Sutter Health organization and still in SF. I recognized him easily from 13 years ago. Anyhow, I know that I need to remain careful about not overdoing super heavy lifting once fully healed, and I will not be able to return to mixed martial arts program I was in, as taking kicks to the chest/belly area, twisting during grappling and MMA and such may not be the best, as it may increase the likelihood of another tear. The crazy heart burn has subsided, I'm off all related medication, minus still taking 1 Pepcid tablet in the mornings while healing. I have questions about how to confirm if my ulcers have healed or are improving, but I am still in my recovery period of 4-6 weeks. So, it is possible to fix this problem without converting to a more severe bariatric surgery, but I think it was worth a try to do just the hernia repair, as it's a better alternative to some of the complications caused by a RNY or other bariatric conversion, as my weight is not dangerously high enough to have those benefits outweighed otherwise. (nothing against anyone who undergoes one of the other surgical options - I'm all for whatever helps someone be healthier and live longer - just noting each of these options come with their own risks and modified maintenance)

Hi -- I too developed a small hiatal hernia discovered on a routine abdominal MRI I now have to have for other health reasons unrelated to my VSG. I was experiencing a lot of abdominal discomfort, belching, burping, reflux after eating oftentimes but didn't know why. I've cut back significantly from eating animal proteins such as red meats, pork, chicken, whole fat dairy. I've been wanting to go vegetarian for the longest time so this seemed to be as good a reason as any to start on that journey. I've been feeling a lot better since making this dietary change. I try to use more olive oil in my cooking as opposed to so much butter also. Anyways, this is what has helped me tremendously but this is a unique experience for everyone.

I wish you all the best in your journey and hope you feel better soon!