HEARTBURN
A burning feeling behind the breastbone, often after eating or when lying down.
العودة إلى الخدماتLAPAROSCOPIC FOREGUT SURGERY
فتق الحجاب الحاجز والارتجاع
Anatomical hiatal repair and individualised reflux control, with careful preservation of swallowing function.
LAPAROSCOPICCRUROPLASTYNISSEN / TOUPET
استكشف العملياتملاحظة: يتوفر التنقل داخل الصفحة بالعربية، بينما يُعرض المحتوى الطبي التفصيلي في هذه الصفحة التخصصية حالياً باللغة الإنجليزية.
ELIXIS · ADVANCED CARE
Two goals: restore anatomy and control reflux while preserving function
Endoscopy, imaging and, when needed, manometry and 24-hour pH monitoring, with or without impedance, help guide the appropriate treatment.
الأعراض
Symptoms that merit assessment
A hiatal hernia is an anatomical displacement of part of the stomach into the chest and may cause no symptoms. Gastro-oesophageal reflux is a separate condition that often coexists and causes many of the typical complaints.
REGURGITATION
Food or sour, bitter fluid coming back towards the mouth.
DIFFICULT SWALLOWING
A sensation that food sticks or pain when swallowing.
CHEST DISCOMFORT
Pressure or pain behind the breastbone or in the upper abdomen that needs appropriate assessment.
EARLY FULLNESS
Bloating, belching, nausea or feeling full after a small meal.
COUGH OR HOARSENESS
Chronic cough, hoarseness or throat irritation, particularly at night.
Symptoms alone prove neither a hiatal hernia nor reflux. Depending on the case, endoscopy, imaging, pH monitoring or manometry may be needed.
العمليات
Hiatal-hernia procedures
Hiatal closure and the antireflux procedure are planned as one functional reconstruction.
01TYPE I
SLIDING HIATAL HERNIA REPAIR
Return of the gastro-oesophageal junction below the diaphragm and repair of the hiatus.
- متى تُبحث
- Objectively confirmed reflux with persistent troublesome symptoms despite appropriate treatment or with complications, and selected large hiatal hernias.
- ماذا تتضمن
- Oesophageal mobilisation, reduction, crural closure and a selected antireflux procedure.
02TYPE II–IV
PARAOESOPHAGEAL HERNIA REPAIR
Reduction of the stomach and any organs displaced into the chest.
- متى تُبحث
- Symptomatic large paraoesophageal hernia, obstruction, anaemia or concern for volvulus. A truly asymptomatic type II–IV hernia may be monitored after shared decision-making.
- ماذا تتضمن
- Sac dissection, restoration of intra-abdominal oesophagus and hiatal closure, with gastropexy or an antireflux procedure only when indicated.
03CRUROPLASTY
POSTERIOR CRUROPLASTY
The diaphragmatic crura are reapproximated around the oesophagus without excessive tension.
- متى تُبحث
- An enlarged hiatus during surgical repair.
- ماذا تتضمن
- Calibrated posterior suture closure; mesh reinforcement is used selectively rather than routinely.
04360°
NISSEN FUNDOPLICATION
A 360° wrap around the lower oesophagus to reinforce the antireflux barrier.
- متى تُبحث
- Selected reflux disease with suitable oesophageal motility.
- ماذا تتضمن
- A short, tension-free wrap after complete anatomical restoration.
05270°
TOUPET FUNDOPLICATION
A 270° posterior partial wrap balancing reflux control and swallowing.
- متى تُبحث
- Selected patients in whom a partial wrap is preferred based on functional assessment.
- ماذا تتضمن
- The fundus is fixed posteriorly and to the sides of the oesophagus without a complete wrap.
06REDO
COMPLEX OR REDO HIATAL REPAIR
Specialist reconstruction for major recurrence or failure of a previous procedure.
- متى تُبحث
- Recurrence, wrap migration, dysphagia or complex anatomy after previous surgery.
- ماذا تتضمن
- Adhesiolysis, careful definition of the altered anatomy and tailored reconstruction, with gastropexy or reinforcement where appropriate.
رسم تشريحي أصلي واقعي للتثقيف — وليس صورة لمريض.
التخطيط والسلامة
Functional assessment before the surgical decision
A hiatal hernia on a test is not by itself an indication for surgery. Symptoms must correlate with anatomy and function, while mesh or gastropexy is considered selectively.
ENDOSCOPY
Assessment of oesophagitis, stomach and anatomy.
FUNCTION
Manometry and 24-hour pH monitoring ± impedance when they affect management.
TENSION FREE
Adequate intra-abdominal oesophageal length and calibrated closure.
SWALLOWING
Wrap selection is tailored to function.
الأسئلة
الأسئلة الشائعة
إجابات مختصرة قبل التقييم الجراحي الفردي.
01Is a minimally invasive approach always possible?
No. It is chosen when safe and meaningfully beneficial. Anatomy, previous surgery and complexity may require another approach or conversion.
02How long does recovery take?
Recovery varies with the procedure, disease severity and general health. The individual plan covers mobilisation, diet, work and exercise.
03Will I stop reflux medication immediately?
Not necessarily. Postoperative medication and diet are individualised and reviewed during follow-up.
الأدلة السريرية
الأدلة السريرية
يعتمد الاختيار النهائي على الحالة السريرية والتشريح والإرشادات الحديثة.
01SAGES · Surgical Treatment of Hiatal HerniasOfficial clinical practice guidelineالمصدر الرسمي02SAGES · GERD Surgical TreatmentGuideline for surgical treatment of refluxالمصدر الرسمي03NHS · Hiatus HerniaSymptoms and when to seek medical assessmentالمصدر الرسمي04NIDDK · GER & GERD in AdultsSymptoms of gastro-oesophageal refluxالمصدر الرسمي
هذا المحتوى تثقيفي ولا يغني عن الفحص الطبي. تُناقش الفوائد والمخاطر والبدائل بصورة فردية.
تقييم جراحي فردي
العملية المناسبة تبدأ بالتشخيص والاستطباب المناسبين.
تُراجع الأعراض والفحوص والبدائل أثناء الاستشارة.
عيادة REA MED والوصول إليها