Laparoscopic Diaphragmatic hernia repair
Every organ in our body has its function, regardless of its size. When an injury or defect occurs, the function of that organ will be affected and impact the entire body. So if you experience any symptoms indicating the dysfunction of any organ of your body, you must go to the specialized doctor immediately for the diagnosis and the beginning of proper treatment to maintain the health of your body and enjoy a better life without any diseases or symptoms.
What is the diaphragm?
The diaphragm is a thin muscular wall or a layer of muscle that separates the thoracic cavity from the abdomen. It has a small opening in the site of the connection of the esophagus to the stomach. When food passes from the esophagus to the stomach, the diaphragm muscles contract to prevent food and juices from returning to the esophagus, hindering a feeling of burning acidity.
What is the role of the diaphragm in the breathing process?
The diaphragm is one of the most important parts of the body that plays a main role in breathing. When we inhale, the diaphragm muscle contracts in the abdominal cavity, so the muscle becomes flat, and the chest cavity becomes deeper and larger. During exhalation, the rib cage slides into its resting position, so the diaphragm takes a dome-shaped position in the chest, and the air inside the lungs is forced to leave the body as the size of the thoracic cavity decreases.
What are the diaphragm parts?
The diaphragm consists of two important parts:
- Peripheral muscles: The peripheral muscles of the diaphragm are composed of many radial muscle fibers.
- Central tendon.
What are the symptoms of diaphragm disorders?
- Gastroesophageal reflux disease (GERD) and severe heartburn.
- Severe pain in the chest, abdomen, or shoulder area.
- Significant lack of oxygen in the blood.
- Strange sounds during breathing.
- Paralysis occurs in rare cases.
- Insomnia and sleeping difficulty due to breathing difficulty.
What are the causes of the diaphragmatic disorders?
The causes of the diseases of the diaphragm vary, but most of them result from anatomical or neurological problems, the most important of which are:
- The occurrence of a hernia of the diaphragm muscle, which causes reflux and severe acidity.
- Congenital disorder.
- Stroke.
- Muscular disturbances.
- Malnutrition.
- Diaphragmatic tumors.
- Radiation therapy.
- Viral and bacterial infections.
- Damage to the phrenic nerve.
- Lupus erythematosus.
What does a diaphragmatic hernia mean?
A diaphragmatic hernia is the entrance of the upper part of the stomach, through the opening in the diaphragm, to the chest cavity. The most common cause of diaphragmatic hernia is the increased pressure in the abdominal cavity, which contains the lower esophagus, stomach, small intestine, pancreas, colon, rectum, liver, gallbladder, kidneys, ureters, and urinary bladder. This pressure may result from several reasons, including coughing, vomiting, severe straining during defecation, or heavy lifting exercises. Sometimes obesity and excess fluid in the abdomen can lead to a diaphragmatic hernia.
What are the main symptoms of a diaphragmatic hernia?
In most cases, many patients with a diaphragmatic hernia do not show any apparent symptoms. Others may have symptoms similar to those of gastroesophageal reflux disease (GERD), which is the reflux of digestive juices from the stomach into the esophagus, and its symptoms include the following:
- Severe acidity and a feeling of burn.
- The sensation of bitterness and a sour taste in the back of the throat.
- Severe bloating.
- Severe pain in the stomach or esophagus.
Although there is a relationship between diaphragmatic hernia and GERD, none appears to cause the other, many cases suffer from diaphragmatic hernia without having GERD, and other cases have GERD without having a diaphragmatic hernia.
Other symptoms of a diaphragmatic hernia include breathing difficulty and chest pain, and since severe chest pain is also a symptom of a heart attack, it is important to immediately contact a doctor or go to the emergency unit when feeling it.
How is a diaphragmatic hernia repaired?
- Dr. Mohamed Abo El Naga uses the laparoscope in this surgery, where 5-6 small incisions are made in the abdominal area, through which the laparoscope and surgical tools are inserted.
- The surgeon uses the laparoscope to take pictures of the internal organs and display them on a screen.
- The hernia is pulled from the diaphragm and returned to the abdominal area.
- The lower esophageal sphincter is improved, as this sphincter works to limit the return of gastric juices and contents into the esophagus.
- The surgeon wraps the upper part of the stomach, which is called the fundus, around the lower part of the esophagus to make the sphincter muscle permanently tight; so that the contents of the stomach do not return to the esophagus again in the future.
The advantages of laparoscopic surgery compared to open surgery include smaller incisions, avoidance of bleeding and pain during and after the surgery, and a faster and shorter recovery period.
Important tips and instructions to reduce gastroesophageal reflux disease:
- Get rid of excess weight and obesity.
- Keep the head elevated about 15 cm from the rest of the body when lying down to keep the gastric juices and contents in the stomach by the force of gravity.
- Refrain from eating fried and fatty foods, as well as foods and drinks that contain a large amount of caffeine, including chocolate and mint.
- Avoid soft drinks and alcoholic beverages.
- Limit the intake of certain foods such as tomato sauce, vinegar, mustard, and hot spices.
- Avoid wearing corsets, belts, or tight clothing, which increases pressure on the stomach and abdomen.
- Take antacids after eating to relieve acid reflux.
- Refrain from smoking.
- Eat daily meals at spaced intervals to give the stomach sufficient time to rest.
- It is preferred to eat at least 3-4 hours before sleeping or lying down and limit snacks before bed.
- Refrain from eating acid-rich foods, such as adding lemon and citrus fruits or their juices, as they may irritate the esophageal lining.
Finally, if you follow these instructions and take antacid medications, but you do not feel any improvement, you should consult a specialist doctor for proper diagnosis and treatment.
