A paraesophageal hernia (a.k.a hiatal hernia) occurs when a portion of the stomach pushes upward through the diaphragm's esophageal hiatus into the chest cavity. This can lead to severe heartburn, difficulty swallowing, chest pressure, or upper abdominal pain. These hernias—along with chronic acid reflux (GERD)—are typically repaired using minimally invasive laparoscopic techniques to reposition the stomach, repair the hiatal defect, and reconstruct the valve at the bottom of the esophagus to restore normal digestive function.
Watch Dr. Taylor perform a paraesophageal hernia repair with Toupet fundoplication. This video highlights the reduction of the hernia, dissection of the hernia sac, closure of the diaphragmatic crura, and construction of a Toupet fundoplication.
Preparing for surgery can feel overwhelming, but taking these key steps ensures your procedure is as safe, smooth, and comfortable as possible.
Nothing After Midnight: Do not eat any solid food, chew gum, or drink liquids after midnight the night before your surgery (unless explicitly instructed otherwise by Dr. Taylor’s team). Having a completely empty stomach is critical for safe general anesthesia.
Blood Thinners & Anti-Inflammatories: Blood thinners (such as Coumadin, Plavix, Eliquis, or Xarelto) and NSAIDs (aspirin, ibuprofen) usually need to be paused several days prior to surgery. You will receive a personalized schedule during your pre-op assessment.
Morning Medications: Take only the morning medications specifically approved by Dr. Taylor or the anesthesia team with a tiny sip of water on the morning of surgery.
Diagnostic Workup: Ensure any pre-operative tests requested by Dr. Taylor—such as an Upper Endoscopy (EGD), esophageal manometry, or pH study—are completed as scheduled to help tailor your specific repair. Also, ensure that you have completed your pre-operative evaluation with your primary care provider, if instructed to do so.
Clothing & Valuables: Wear loose, comfortable clothing that is easy to step into and button or zip over your abdomen. Leave jewelry, watches, and valuables at home.
This procedure is typically followed by a brief overnight stay in order to assure that you tolerate liquid diet afterwards.
Follow strict dietary instructions over the first 6 weeks in order to allow esophageal swelling to heal. See button below to download these instructions. It is imperative to not try to advance too quickly to prevent setbacks and complications.
Activity & Lifting: Avoid heavy lifting over 15–20 lbs for 4–6 weeks to protect the diaphragm repair. Gentle walking is encouraged immediately.
Click to view or download the patient information handout in Google Doc format for laparoscopic hiatal hernia repair and fundoplication
Click to view or download the dietary instructions that must be followed after hiatal hernia repair
Click to view or download a brief handout about GERD, management strategies, and when to consider anti-reflux surgery.