HEARTBURN
A burning feeling behind the breastbone, often after eating or when lying down.
NAZAD NA USLUGELAPAROSCOPIC FOREGUT SURGERY
HIJATALNA KILA I REFLUKS
Anatomical hiatal repair and individualised reflux control, with careful preservation of swallowing function.
LAPAROSCOPICCRUROPLASTYNISSEN / TOUPET
POGLEDAJTE OPERACIJENapomena: navigacija na stranici dostupna je na srpskom. Detaljan medicinski sadržaj ove stručne stranice trenutno je prikazan na engleskom.
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.
SIMPTOMI
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.
OPERACIJE
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.
- KADA SE RAZMATRA
- Objectively confirmed reflux with persistent troublesome symptoms despite appropriate treatment or with complications, and selected large hiatal hernias.
- ŠTA OBUHVATA
- 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.
- KADA SE RAZMATRA
- Symptomatic large paraoesophageal hernia, obstruction, anaemia or concern for volvulus. A truly asymptomatic type II–IV hernia may be monitored after shared decision-making.
- ŠTA OBUHVATA
- 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.
- KADA SE RAZMATRA
- An enlarged hiatus during surgical repair.
- ŠTA OBUHVATA
- 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.
- KADA SE RAZMATRA
- Selected reflux disease with suitable oesophageal motility.
- ŠTA OBUHVATA
- A short, tension-free wrap after complete anatomical restoration.
05270°
TOUPET FUNDOPLICATION
A 270° posterior partial wrap balancing reflux control and swallowing.
- KADA SE RAZMATRA
- Selected patients in whom a partial wrap is preferred based on functional assessment.
- ŠTA OBUHVATA
- 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.
- KADA SE RAZMATRA
- Recurrence, wrap migration, dysphagia or complex anatomy after previous surgery.
- ŠTA OBUHVATA
- Adhesiolysis, careful definition of the altered anatomy and tailored reconstruction, with gastropexy or reinforcement where appropriate.
Originalna realistična anatomska ilustracija u edukativne svrhe — nije fotografija pacijenta.
PLANIRANJE I BEZBEDNOST
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.
PITANJA
ČESTA PITANJA
Kratki odgovori pre individualne hirurške procene.
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.
KLINIČKI DOKAZI
KLINIČKI DOKAZI
Konačan izbor zavisi od kliničke slike, anatomije i savremenih smernica.
01SAGES · Surgical Treatment of Hiatal HerniasOfficial clinical practice guidelineZVANIČNI IZVOR02SAGES · GERD Surgical TreatmentGuideline for surgical treatment of refluxZVANIČNI IZVOR03NHS · Hiatus HerniaSymptoms and when to seek medical assessmentZVANIČNI IZVOR04NIDDK · GER & GERD in AdultsSymptoms of gastro-oesophageal refluxZVANIČNI IZVOR
Sadržaj je informativan i ne zamenjuje pregled. Koristi, rizici i alternative razmatraju se individualno.
INDIVIDUALNA HIRURŠKA PROCENA
Prava operacija počinje pravom indikacijom.
Simptomi, nalazi i alternative razmatraju se na konsultaciji.
Ordinacija REA MED i dolazak