Sixty-minute stomach operation could banish heartburn in weeks for thousands of patients with a painful hernia

Patients with a painful hernia affecting the stomach will soon receive a groundbreaking procedure that eradicates the condition with little to no long-term side effects.

Thousands of people develop this problem every year, which occurs when part of the stomach pushes through the diaphragm into the chest, causing uncomfortable heartburn and bloating.

Also known as hiatus hernia, men over age 50 are at greatest risk and have traditionally been treated with invasive surgery involving multiple incisions in the chest. The treatment can also lead to lifelong side effects such as swallowing problems and internal bleeding.

But the new 60-minute operation, which was performed for the first time on the NHS earlier this month, involves just a single small incision – no bigger than a centimeter – in the chest.

The hernia is pushed out of the chest with a surgical device and the top of the diaphragm is secured with stitches to prevent the stomach from rising again.

Thousands of people develop a hernia every year, which occurs when part of the stomach pushes through the diaphragm into the chest, causing uncomfortable heartburn and bloating.

A robotic surgical instrument is then guided through the mouth into the stomach, also using sutures to collapse the tissue at the top of the stomach to hold it in place.

Experts claim that patients who have struggled with heartburn for decades see their symptoms subside just weeks later.

‘This is a game changer for the treatment of gastric hernias,’ says Dr Rehan Haidry, a gastroenterologist at University College London Hospital and the first doctor in Britain to perform the operation. ‘It is less drastic than the current operation. This will be the best NHS treatment for this uncomfortable condition.”

Doctors still don’t know what causes these types of hernias, but most think they occur when the diaphragm, the muscle that sits underneath the lungs, weakens. This allows the stomach to rise into the esophagus – the tube that connects the mouth to the stomach.

People who are overweight or pregnant are also at risk of developing a hiatal hernia.

It is estimated that around a third of people over 50 have one, as it often goes unnoticed as only a small part of the stomach rises and does not cause any noticeable problems. But when a large portion of the stomach is squeezed into the chest area, it can cause debilitating symptoms.

These include painful heartburn or acid reflux – where small amounts of food or stomach acid back up into the esophagus. Patients also report bad breath, bloating and difficulty swallowing.

Proton pump inhibitors (PPIs), the medications commonly prescribed to address acid reflux, are designed to prevent the stomach from producing too much acid, but may be ineffective.

“This is a problem that can affect your entire life,” says Dr. Haidry. “Many people even report feeling the hernia in their chest, which they liken to a tennis ball stuck under their ribs.”

Unlike the invasive traditional surgery for a hiatal hernia, the new procedure requires only one incision to secure the diaphragm with sutures.

Once completed, a surgical suturing instrument called an EsophyX is passed down the throat until it reaches the top of the stomach. There it is used to twist the upper end of the stomach, creating a loose knot, and then staple it in place. This reduces the opening between the stomach and the esophagus, preventing acid from rising and causing heartburn.

Previously, this was done through a new incision in the chest, which required several organs to be removed, which entailed the risk of internal bleeding.

Research shows that the procedure – which is already regularly performed in the US – has few side effects.

‘It is minimally invasive compared to current NHS treatment, so patients can get back on their feet and eat normally much faster,’ says Dr Haidry. ‘And they are much less likely to have swallowing problems or bloating.’

He adds: ‘One of my recent patients was a Londoner in his mid-forties who had been living with a gastric hernia for almost twenty years. He suffered from terrible acid reflux every day, despite his medications.

‘The procedure took less than an hour and we were able to discharge him the next morning with nothing but a half-inch scar on his chest to show for it.

‘He’s doing very well. He has much less acid reflux than before and this will only get better as time goes on.’