Journal article
Concurrent hiatal hernia repair and gastric bypass as an adjunct in the treatment of hiatal hernia in populations with obesity
Surgical endoscopy, Vol.39, pp.4801-4805
06/16/2025
DOI: 10.1007/s00464-025-11854-7
PMCID: PMC12287242
PMID: 40523974
Appears in UI Libraries Support Open Access
Abstract
Minimally invasive hiatal hernia repair with fundoplication (HHR) is the standard of care for hiatal hernias but has a high risk of recurrence even in populations without obesity. Concomitant roux-en-y gastric bypass (RYGB) with HHR may mitigate the increased risk of hiatal hernia recurrence in patients with obesity while also addressing obesity-related comorbidities. There is a paucity of data on this procedure. It is hypothesized that a concomitant RYGB with HHR is safe and effective in patients with obesity.
This is a single institution retrospective review of adult patients who underwent concomitant RYGB with HHR from 2014-2023. Patient charts were reviewed to collect data on complications, weight loss, GERD symptom resolution, and improvement in other obesity-related comorbidities. Outcomes were measured at one-, three-, and five-year follow-up.
Sixty-four patients met inclusion criteria. Fifty-three patients had primary and eleven patients had revisional surgery. There was one (2%) perioperative complication that required intervention, three (4%) unplanned readmissions for PO intolerance, and four patients (8%) treated for marginal ulcer. Resolution of heartburn/reflux symptoms was 86% at one year, 70% at 3 year, and 59% at 5 year follow-up. Improvement in diabetes (80%), hypertension (75%), and hyperlipidemia (33%) were noted at 5 years. The change in BMI and %TWL at 5 years for primary procedures was -11.5 kg/m
and 37.7%, respectively. For revisional procedures, change in BMI was -2.4 kg/m
and %TWL was 3.6%.
Durability of a HHR in the setting of obesity is poor. Concomitant RYGB with HHR is safe and effective for treating GERD while also improving obesity and obesity-associated comorbidities.
Details
- Title: Subtitle
- Concurrent hiatal hernia repair and gastric bypass as an adjunct in the treatment of hiatal hernia in populations with obesity
- Creators
- Leon Siegel - Department of Surgery, University of Iowa Health Care, 200 Hawkins Dr, Iowa City, IA, 4628 JCP, USARory Carroll - University of IowaDakota T Thompson - University of IowaRyan Lehmann - University of IowaJessica Smith - University of IowaPeter Nau - Department of Surgery, University of Iowa Health Care, 200 Hawkins Dr, Iowa City, IA, 4628 JCP, USA. peter-nau@uiowa.edu
- Resource Type
- Journal article
- Publication Details
- Surgical endoscopy, Vol.39, pp.4801-4805
- DOI
- 10.1007/s00464-025-11854-7
- PMID
- 40523974
- PMCID
- PMC12287242
- NLM abbreviation
- Surg Endosc
- ISSN
- 1432-2218
- eISSN
- 1432-2218
- Publisher
- Springer Nature
- Language
- English
- Date published
- 06/16/2025
- Academic Unit
- Surgery
- Record Identifier
- 9984832189302771
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