Advanced Minimally Invasive Surgery for Hiatus Hernia and Chronic Acid Reflux at Bombay Gastro & Cancer Institute, Bathinda
A patient presented with a long history of gastroesophageal reflux disease (GERD), experiencing persistent acidity, heartburn, regurgitation of food, chest discomfort, chronic reflux, and disturbed sleep despite prolonged treatment with anti-acid medications.
Further evaluation with upper gastrointestinal endoscopy and imaging confirmed a hiatus hernia, in which a portion of the stomach had migrated through the diaphragmatic opening into the chest. This abnormal anatomy resulted in chronic acid reflux and persistent GERD symptoms.
Advanced Laparoscopic Surgical Management
The patient underwent Laparoscopic Hiatus Hernia Repair with Floppy Nissen (360°) Fundoplication, performed by Dr. Raman Garg, Consultant Surgical Gastroenterologist, Advanced GI, Laparoscopic & HPB Surgeon at Bombay Gastro & Cancer Institute, Bathinda.
The procedure included:
- Complete laparoscopic reduction of the herniated stomach into the abdominal cavity.
- Careful dissection of the esophagus and restoration of normal anatomy.
- Repair of the enlarged diaphragmatic hiatus using non-absorbable sutures.
- Creation of a Floppy 360° Nissen Fundoplication, in which the upper part of the stomach (fundus) was wrapped around the lower esophagus to recreate a competent anti-reflux valve while preserving normal swallowing.
The entire operation was completed using minimally invasive laparoscopic (keyhole) surgery, avoiding the need for a large abdominal incision.
Postoperative Recovery
The patient recovered smoothly after surgery.
- Early mobilization.
- Gradual progression from liquids to a soft diet.
- Significant relief from acid reflux and heartburn.
- Minimal postoperative pain.
- Short hospital stay with discharge in satisfactory condition.
Why This Case Is Important
Hiatus hernia is one of the most common causes of chronic gastroesophageal reflux disease (GERD). Although many patients improve with medications, some continue to experience persistent symptoms or develop complications such as esophagitis, Barrett's esophagus, recurrent aspiration, chronic cough, strictures, and poor quality of life.
Laparoscopic Hiatus Hernia Repair with Floppy Nissen Fundoplication is considered the gold standard surgical treatment for appropriately selected patients. It restores normal anatomy, strengthens the anti-reflux barrier, controls acid reflux, preserves swallowing function, and provides durable long-term symptom relief with all the benefits of minimally invasive surgery.
This case highlights Dr. Raman Garg's expertise in advanced upper gastrointestinal surgery and minimally invasive anti-reflux procedures.
Expert Hiatus Hernia and GERD Surgery by Dr. Raman Garg
Dr. Raman Garg is a leading Surgical Gastroenterologist in Bathinda, specializing in the treatment of hiatus hernia, GERD (acid reflux), swallowing disorders, gallbladder stones, liver diseases, pancreatic disorders, colorectal diseases, gastrointestinal cancers, abdominal wall hernias, and other complex gastrointestinal conditions.
He performs advanced laparoscopic anti-reflux surgery, upper GI surgery, hepatopancreatobiliary (HPB) surgery, colorectal surgery, and minimally invasive gastrointestinal procedures using evidence-based surgical techniques.
Patients from Bathinda, Punjab, Haryana, Rajasthan, and neighbouring states seek treatment from Dr. Raman Garg for both routine and complex gastrointestinal disorders.
Diagnosis: Hiatus Hernia with Chronic Gastroesophageal Reflux Disease (GERD)
Procedure Performed: Laparoscopic Hiatus Hernia Repair and Floppy Nissen (360°) Fundoplication
Operating Surgeon: Dr. Raman Garg, Surgical Gastroenterologist, Advanced GI, Laparoscopic & HPB Surgeon, Bombay Gastro & Cancer Institute, Bathinda
Outcome: Successful minimally invasive anti-reflux surgery with excellent postoperative recovery, short hospital stay, and significant relief of GERD symptoms.
About Dr. Raman Garg
Dr. Raman Garg is a Consultant Surgical Gastroenterologist, Advanced GI, Laparoscopic and HPB Surgeon at Bombay Gastro & Cancer Institute, Bathinda. He specializes in gastrointestinal cancer surgery, liver, pancreas and bile duct surgery, colorectal surgery, hernia surgery, upper GI surgery, emergency abdominal surgery, and advanced minimally invasive procedures.
Patient identity has been withheld to maintain confidentiality. This case is shared for educational purposes with appropriate consent and privacy safeguards.
