Hiatal Hernia Repair and Fundoplication for Reflux in Cairo
Hiatal hernia repair returns the stomach to its normal position below the diaphragm and, usually combined with a fundoplication, rebuilds the valve that stops acid reflux. It is performed by laparoscopic surgery and is considered for people whose reflux or hernia is not controlled by medication and lifestyle changes.
Hiatus hernia and reflux explained
A hiatus hernia happens when part of the stomach slides up through the opening in the diaphragm (the hiatus) into the chest. Small sliding hernias are common, often cause no symptoms and need no treatment. When they weaken the junction between the gullet and stomach, they can contribute to gastro-oesophageal reflux disease (GERD): heartburn, acid regurgitation, chest discomfort, a sour taste, cough or hoarseness.
A less common type, the paraoesophageal hernia, pushes a larger part of the stomach up beside the gullet. These can cause pain after eating, early fullness, vomiting or anaemia, and occasionally twist, which is an emergency.
Medication first: when surgery is considered
Most reflux is managed well with lifestyle changes (weight loss if needed, smaller evening meals, raising the head of the bed, cutting down smoking and alcohol) and acid-suppressing medicines such as proton pump inhibitors. Surgery is not the first step, and not everyone with heartburn is a candidate.
Anti-reflux surgery is considered when reflux is confirmed by tests and symptoms persist despite good medical treatment, when regurgitation remains troublesome even though acid is controlled, when someone who responds to medication does not want lifelong treatment, or when there are complications. Symptomatic paraoesophageal hernias are usually repaired. If your main problem is weight, bariatric surgery may treat reflux and weight together, and this is discussed honestly.
Tests before hiatal hernia repair
Because the symptoms of reflux overlap with other conditions, tests come before any decision. An upper endoscopy looks at the gullet and stomach and shows the hernia and any inflammation. A pH or pH-impedance study measures reflux over 24 hours or more, and oesophageal manometry checks how well the gullet squeezes, which guides the type of wrap. A barium swallow or CT scan may be used to map larger hernias.
These tests protect you from an operation that would not help: if the symptoms are not caused by reflux, a fundoplication will not relieve them.
How laparoscopic fundoplication works
Under general anaesthetic, five small incisions are used. The surgeon brings the stomach back into the abdomen, removes the hernia sac and narrows the widened hiatus with stitches, sometimes reinforced. The top of the stomach (the fundus) is then wrapped around the lower gullet: a full 360° Nissen wrap or a partial wrap such as a Toupet, chosen according to your tests and symptoms.
The operation commonly takes about two hours, longer for large paraoesophageal hernias, and most people stay one or two nights. If you are also being assessed for gallstones, our page on laparoscopic gallbladder removal explains that procedure.
Side effects, risks and the recovery diet
Some difficulty swallowing in the first weeks is expected while swelling settles, which is why you follow a liquid then soft diet for a few weeks, eating slowly and avoiding bread and dry meat at first. Bloating and reduced ability to belch or vomit are common early and usually improve. Persistent swallowing difficulty is uncommon and may need dilation or revision.
Other risks include bleeding, injury to the gullet or stomach, collapse of part of the lung from air in the chest, and the hernia or reflux returning over the years, which is more likely with large hernias. Most people return to desk work within about two to three weeks.
Treats the cause
Repairs the hernia and rebuilds the anti-reflux valve.
Less medication
Many patients reduce or stop daily reflux tablets.
Keyhole approach
Small incisions and a short hospital stay.
Tailored wrap
Full or partial wrap chosen from your test results.
Recovery timeline
One to two nights in hospital. Sips of fluid, then a liquid diet. Walking from the first day.
Soft, moist food in small portions, eaten slowly. Desk work often resumes from week two or three.
Gradual return to a normal diet and to exercise and lifting as advised at follow-up.
Cost & what’s included
The cost is quoted after the tests and consultation, because it depends on the size and type of hernia, whether mesh reinforcement is needed, the tests required beforehand, the hospital and the length of stay. Ask for a personalised quote and we will explain what it includes.
A personalised quote
You receive a detailed quote after your assessment, covering the surgeon, anaesthesia, hospital and stay.
Frequently asked questions
Does a hiatal hernia always need surgery?
No. Many small sliding hiatus hernias cause no symptoms or only mild reflux that is well controlled with lifestyle changes and medication. Surgery is considered when reflux is confirmed by tests and remains troublesome despite treatment, when there are complications, or for symptomatic paraoesophageal hernias.
Will I still need reflux tablets after fundoplication?
Many people are able to stop or greatly reduce their acid-suppressing medication after a successful fundoplication. Over the years, some find that occasional or regular medication is needed again. Your surgeon will discuss realistic expectations based on your tests and the size of your hernia.
What can I eat after hiatal hernia surgery?
You start with fluids, then move to soft, moist foods for a few weeks, eating small portions slowly and chewing well. Bread, dry meat and fizzy drinks are usually avoided at first because they can stick or cause bloating while swelling settles. Most people return to a normal diet by about six weeks.
Is laparoscopic fundoplication safe?
It is an established keyhole operation with a good safety record when patients are carefully selected and tested beforehand. Like any surgery it has risks, including temporary swallowing difficulty, bloating, bleeding and, uncommonly, injury to the gullet or stomach. These are explained to you in detail before you decide.
How long does recovery from fundoplication take?
Most people stay one or two nights in hospital and return to desk work within about two to three weeks. The soft diet usually lasts a few weeks, and heavy lifting is avoided for around six weeks to protect the repaired hiatus. Your follow-up visit guides each step.
References
- Guidelines for the management of hiatal hernia (SAGES) — Surgical Endoscopy
- ACG Clinical Guideline for the Diagnosis and Management of Gastroesophageal Reflux Disease — American Journal of Gastroenterology
- Hiatus hernia — NHS
- Gastro-oesophageal reflux disease and dyspepsia in adults (CG184) — NICE
This information is general education and does not replace a medical examination. Treatment decisions are made after assessing your case.
Have a question about your case?
Send your question and the clinic team will contact you to arrange a consultation, usually within the same working day.
- An honest assessment of your case
- A clear plan before any decision
- A detailed quote after examination