Hiatal Hernia Surgery in

Austin, TX

A hiatal hernia occurs when the upper part of the stomach moves through an opening in the diaphragm and into the chest. It is different from a groin or abdominal wall hernia: it usually does not create a visible bulge on the outside of the body. Many people have a small hiatal hernia without knowing it. Others experience reflux or symptoms related to a larger hernia.

At ATX Robotic Surgery, our general surgeons review your symptoms, test results, and overall health to help determine whether observation, medical treatment, or surgery makes sense for you.

Types and symptoms of hiatal hernias

In a sliding hiatal hernia, the junction of the esophagus and stomach moves upward through the diaphragm. This common type may be associated with gastroesophageal reflux disease (GERD). Reflux can cause heartburn, a sour taste or regurgitation, and irritation in the throat or chest.

In a paraesophageal hernia, part of the stomach rises next to the esophagus. Larger hernias can cause difficulty swallowing, a feeling of fullness after small meals, chest or upper abdominal discomfort, or shortness of breath. Symptoms vary, and these complaints can have causes other than a hernia. Severe chest pain or trouble breathing needs immediate medical evaluation.

Does a hiatal hernia need surgery?

A diagnosis alone does not mean an operation is necessary. People without troublesome symptoms may need monitoring rather than repair. Reflux symptoms may improve with changes in eating habits, other lifestyle measures, and medication. Surgery may be considered when symptoms remain difficult to control, tests show significant reflux or its complications, or a larger paraesophageal hernia causes symptoms or raises concern for future problems.

The decision for an asymptomatic paraesophageal hernia is individualized. Your surgeon will weigh the hernia's size and type, your health, and the risks of repair and continued observation with you.

Evaluation before surgery

Your evaluation may include an upper endoscopy to look at the esophagus and stomach, an imaging study that shows the anatomy during swallowing, and tests of acid reflux or how the esophagus moves food. The tests needed depend on your symptoms and the proposed operation. This information helps distinguish symptoms caused by the hernia from other conditions and guides the repair plan.

How is a hiatal hernia repaired?

The surgeon brings the stomach back into the abdomen and narrows the enlarged opening in the diaphragm. An anti-reflux procedure may be added. One option is fundoplication, in which part of the stomach is wrapped around the lower esophagus to help reduce reflux. Your surgeon will discuss whether this is appropriate and what it may mean for swallowing and reflux afterward. Mesh use at the hiatus is individualized rather than automatic.

A hiatal hernia repair may be performed through small incisions using laparoscopic or robotic-assisted instruments. During robotic-assisted surgery, the surgeon controls every instrument; the system does not operate on its own. Some patients need an open approach, and the surgical plan may change if that is safer. Robotic assistance does not guarantee a shorter stay, less pain, or freedom from recurrence.

Recovery and possible risks

After surgery, you may follow a temporary liquid or soft-food plan while swallowing and the repaired area recover. Your team will provide instructions for eating, activity, medicines, and follow-up. Mild temporary swallowing difficulty or bloating can occur; tell your surgeon if symptoms persist or worsen. Recovery time and hospital stay depend on the size and complexity of the hernia and your health.

Risks include bleeding, infection, injury to nearby organs, difficulty swallowing, persistent or recurrent reflux, and recurrence of the hernia. Your surgeon will explain the expected benefit and risks of your proposed operation and the alternatives to it.

Schedule a consultation with ATX Robotic Surgery if you have been diagnosed with a hiatal hernia and want to understand your options. Seek emergency care for severe chest pain, trouble breathing, severe or worsening abdominal pain, or persistent vomiting rather than waiting for an office visit.

schedule a consultation

Pre-Consultation Information

  • Please bring a Photo ID and insurance information, a list of medications you are currently taking, and any relevant medical records or office visit notes.

  • Our team will discuss any questions or concerns, review your medical history to understand symptoms or allergies, perform a focused physical exam, and discuss the next steps for a plan tailored to you.

  • Write down your symptoms and when they occur, note any activities that make symptoms better or worse, plan to bring a family member if helpful.

Hiatal Hernia Surgery FAQs

  • No. A hiatal hernia is a change in anatomy; GERD is the backward flow of stomach contents into the esophagus. A hiatal hernia can contribute to GERD, but a person can have either condition without the other.

  • Medication may reduce stomach acid and improve reflux symptoms, but it does not close the opening in the diaphragm. Many people manage their symptoms without needing an operation.

  • It is a hiatal hernia in which part of the stomach moves into the chest beside the esophagus. It may cause few symptoms or problems with eating, swallowing, chest discomfort, or breathing. The need for repair depends on the individual's symptoms, anatomy, and health.

  • Your surgeon may recommend an upper endoscopy, imaging of the esophagus and stomach, acid testing, or a test of esophageal muscle function. Not everyone needs every test.

  • Possibly. Some hiatal repairs include a fundoplication or another anti-reflux procedure. The choice depends on your symptoms, testing, and the type of hernia. Your surgeon should explain the planned steps before surgery.

  • Not necessarily. Whether to use mesh at the diaphragm is a decision based on the particular hernia and repair. Ask your surgeon why mesh is or is not recommended in your case.

  • Many patients follow a temporary progression from liquids to soft foods and then a more regular diet. Follow the specific plan from your team, since the timing depends on the operation and your recovery.

  • Yes. Repair can improve symptoms, but the hernia or reflux can recur. Some patients continue to need medication or further evaluation. Your surgeon can discuss the expected result and long-term follow-up for your case