Hiatal Hernia with Gastroesophageal Reflux

The thoracic surgeons at Yale offer their expertise in dealing with conditions such as hiatal hernia (HH) with gastroesophageal reflux disease (GERD). A number of mechanisms, both anatomic and functional, contribute to the development of symptoms with HH/GERD. In simplified terms, the hiatal hernia distorts the valve at the end of the esophagus (leading to the stomach) and results in an incompetent valve that allows for the reflux of stomach contents. Giant paraesophageal hernias also fall into this category of diseases but account for a greater distortion of the stomach. Hereditary factors contribute to the development of these conditions. Patients can present with severe heart burn, pain in the central part of their upper abdomen and lower chest, difficulty swallowing, as well as with respiratory symptoms due to the reflux of acidic gastric vapors. Occasionally, patients may present in a more emergent fashion with a stomach that is twisted. Treatment of this condition may include a laparoscopic or open approach to treat this condition and may include the reduction of the hernia and wrapping procedure (fundoplication) to restore the valve. Occasionally, patients who have had a previous operation to correct their HH/GERD may require an approach via the chest (thoracoscopic or open) to address their recurrent reflux.

As faculty of the Yale School of Medicine Department of Surgery, our nationally and internationally renowned surgeons are continually redefining standards of care through their comprehensive skill, innovative procedures, ongoing research, and the application of evidence-based medicine.

The thoracic surgery practice encompasses all aspects of your total esophageal health, including diagnosis, treatment, and follow-up care. To assure a comprehensive treatment approach, our surgeons work as part of a multidisciplinary team at Yale, composed of other nationally and internationally recognized experts in esophageal disease. By collectively reviewing your entire case, our multidisciplinary team can determine the best diagnostic and treatment options for you. 

Our surgeons are highly skilled at performing even the most advanced surgical techniques for both common and complex conditions. At Yale Thoracic Surgery, we know that the surgical process can feel intimidating, which is why our surgeons will walk you through the process, step by step, so that you understand the procedure and feel comfortable with your treatment options.