Laparoscopic Repair & Nissen Fundoplication for GERD & Reflux
A hiatal hernia occurs when a portion of the stomach pushes upward through the diaphragm into the chest cavity. It is a common cause of chronic acid reflux (GERD), heartburn, and regurgitation. Dr. Richard Nguyen at Lifetime Surgical diagnoses and treats hiatal hernias using minimally invasive laparoscopic surgery with highly effective, long-lasting results.
Many small hiatal hernias cause no symptoms. When they occur:
If you’ve been struggling with chronic heartburn, regurgitation, or have been told you have a hiatal hernia, Dr. Richard Nguyen at Lifetime Surgical can help you explore all treatment options. Schedule a consultation at our San Jose or Los Gatos offices.
Management is guided by hernia type, symptom severity, and response to medical therapy.
For sliding hernias causing GERD, Dr. Nguyen typically recommends proton pump inhibitors (PPIs) such as omeprazole or pantoprazole, combined with lifestyle changes: weight loss, avoiding late meals, elevating the head of bed, reducing alcohol and caffeine.
Large Type II–IV paraesophageal hernias require repair even if asymptomatic, due to risk of gastric volvulus, strangulation, and perforation.
Dr. Nguyen performs laparoscopic repair through 5 small incisions in the upper abdomen in three key steps:
The herniated stomach is gently pulled back into the abdominal cavity.
The hiatal opening in the diaphragm is closed with permanent sutures, often reinforced with mesh to reduce recurrence.
Dr. Nguyen wraps the upper stomach around the lower esophagus to create a new valve preventing acid reflux. The Nissen fundoplication (360° wrap) provides excellent long-term GERD control. A partial Toupet or Dor wrap may be used when esophageal motility is reduced.
Laparoscopic hiatal hernia repair is covered by most insurance plans when medically indicated — typically when symptoms persist despite medication, or a large paraesophageal hernia is present.
Lifetime Surgical accepts approximately 20 insurance plans. Pre-authorization is usually required; our team assists patients through this process. Call 408-850-0176 to verify your coverage.
For many patients, surgery offers a more durable solution than lifelong medication. Studies show laparoscopic fundoplication controls GERD symptoms in 90–95% of patients long-term, allowing most to stop or significantly reduce acid-suppressing medication. The decision depends on hernia size, symptom severity, and your personal preference — Dr. Nguyen will walk you through the pros and cons at your consultation.
Yes, though it takes time. A fundoplication tightens the lower esophageal valve, so patients experience some difficulty swallowing and bloating for the first 4–8 weeks. Following Dr. Nguyen’s dietary progression (liquids → soft foods → normal diet) is essential. The vast majority of patients eat fully normally after this adjustment period.
The repair is intended to be durable. About 5–10% of patients may develop some degree of hernia recurrence or wrap failure over 10 years, which can sometimes require revision surgery. Maintaining a healthy weight and avoiding heavy straining helps protect the repair long-term.
This is a common scenario — hiatal hernia and GERD can mimic cardiac chest pain very convincingly. If cardiac causes have been ruled out, a consultation with Dr. Nguyen along with an upper endoscopy and possibly pH monitoring can confirm whether a hiatal hernia is responsible and whether surgery is appropriate.
Many small hiatal hernias cause no symptoms. When they do occur:
Management is guided by hernia type, symptom severity, and response to medical therapy.
For sliding hernias causing GERD, Dr. Nguyen typically recommends a trial of proton pump inhibitors (PPIs) such as omeprazole or pantoprazole, combined with lifestyle modifications: weight loss, avoiding late meals, elevating the head of bed, reducing alcohol and caffeine.
Large Type II–IV paraesophageal hernias require repair even if asymptomatic, due to risk of gastric volvulus (stomach twisting), strangulation, and perforation.
Dr. Nguyen performs laparoscopic repair through 5 small incisions in the upper abdomen. The procedure involves three steps:
The herniated stomach is gently pulled back into the abdominal cavity.
The hiatal opening in the diaphragm is closed with permanent sutures, often reinforced with mesh to reduce recurrence risk.
Dr. Nguyen wraps the upper stomach (fundus) around the lower esophagus to create a new valve preventing acid reflux. The Nissen fundoplication (360° wrap) provides excellent GERD control. A partial wrap (Toupet or Dor) may be used when esophageal motility is reduced.
Laparoscopic hiatal hernia repair is covered by most insurance plans when medically indicated — typically when symptoms persist despite medication, or a large paraesophageal hernia is present.
Lifetime Surgical accepts approximately 20 insurance plans. Pre-authorization is usually required; our team assists patients through this process. Call 408-850-0176 to verify your coverage before your consultation.
Many small hiatal hernias cause no symptoms. When they occur:
Management is guided by hernia type, symptom severity, and response to medical therapy.
For sliding hernias causing GERD, Dr. Nguyen typically recommends proton pump inhibitors (PPIs) such as omeprazole or pantoprazole, combined with lifestyle changes: weight loss, avoiding late meals, elevating the head of bed, reducing alcohol and caffeine.
Large Type II–IV paraesophageal hernias require repair even if asymptomatic, due to risk of gastric volvulus, strangulation, and perforation.
Dr. Nguyen performs laparoscopic repair through 5 small incisions in the upper abdomen in three key steps:
The herniated stomach is gently pulled back into the abdominal cavity.
The hiatal opening in the diaphragm is closed with permanent sutures, often reinforced with mesh to reduce recurrence.
Dr. Nguyen wraps the upper stomach around the lower esophagus to create a new valve preventing acid reflux. The Nissen fundoplication (360° wrap) provides excellent long-term GERD control. A partial Toupet or Dor wrap may be used when esophageal motility is reduced.
Laparoscopic hiatal hernia repair is covered by most insurance plans when medically indicated — typically when symptoms persist despite medication, or a large paraesophageal hernia is present.
Lifetime Surgical accepts approximately 20 insurance plans. Pre-authorization is usually required; our team assists patients through this process. Call 408-850-0176 to verify your coverage.
For many patients, surgery offers a more durable solution than lifelong medication. Studies show laparoscopic fundoplication controls GERD symptoms in 90–95% of patients long-term, allowing most to stop or significantly reduce acid-suppressing medication. The decision depends on hernia size, symptom severity, and your personal preference — Dr. Nguyen will walk you through the pros and cons at your consultation.
Yes, though it takes time. A fundoplication tightens the lower esophageal valve, so patients experience some difficulty swallowing and bloating for the first 4–8 weeks. Following Dr. Nguyen’s dietary progression (liquids → soft foods → normal diet) is essential. The vast majority of patients eat fully normally after this adjustment period.
The repair is intended to be durable. About 5–10% of patients may develop some degree of hernia recurrence or wrap failure over 10 years, which can sometimes require revision surgery. Maintaining a healthy weight and avoiding heavy straining helps protect the repair long-term.
This is a common scenario — hiatal hernia and GERD can mimic cardiac chest pain very convincingly. If cardiac causes have been ruled out, a consultation with Dr. Nguyen along with an upper endoscopy and possibly pH monitoring can confirm whether a hiatal hernia is responsible and whether surgery is appropriate.
If you’ve been struggling with chronic heartburn, regurgitation, or have been told you have a hiatal hernia, Dr. Richard Nguyen at Lifetime Surgical can help you explore all treatment options. Schedule a consultation at our San Jose or Los Gatos offices.
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