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JAMA Patient Page
December 24/31, 2019

Paraesophageal Hernia Repair and Fundoplication

Author Affiliations
  • 1Stanford Hospital, Stanford, California
JAMA. 2019;322(24):2450. doi:10.1001/jama.2019.17390

A paraesophageal hernia repair involves restoring the normal anatomy of the esophagus and stomach by closing a defect in the diaphragm.

The diaphragm is a dome-shaped muscle separating the chest and the abdomen. Paraesophageal hernias are caused by an opening or defect in the diaphragm that may cause displacement of the stomach, small intestine, colon, and spleen out of the abdomen, where they normally reside, and into the chest. Not all paraesophageal hernias require repair, so patients should discuss the risks and benefits of an operation with their surgeon. A very large hernia or symptoms like heartburn, chest pressure, and inability to eat well may warrant surgery.