23/11/2025
Sending home yet another senior citizen with a" Large Para esophageal hernia" , where the whole of the stomach had migrated into the chest causing dysphagia ( difficulty to swallow).
She had an associated condition called Myeasthenia gravis , an auto immune neuro muscular condition where in the patient develops weakness and rapid fatigue of the skeletal muscles. This made it challenging to manage.
We managed her medically for almost 6-7 months with medications and optimised all her associated problems, then took her up for a surgery. I performed a 4 hour difficult surgery, repositioned the stomach into the abdomen, repaired the large defect in the diaphragm ( Hiatus ) with a mesh and did a partial fundoplication.
This surgery is an usual surgery which we do in 1 &1/2 hours for a GERD patient with a small hiatus hernia.
A large and long standing para esophageal hernia with Myesthenia gravis is a challenging situation.
I acknowledge the team of anesthesia lead by Dr Girish Reddy, esp Dr Akhila and Dr Suhasini, the Neurologist Dr Shyam Jaiswal, Pulmonologist Dr Mohammed Rafi at KIMS Hospital Gachibowli.
She went home without any problems and this is the result of excellent team effort and coordination.
Dr Datta Ram U
Senior Surgical Gastroenterologist
Advanced Laparoscopic Robotic Surgeon
GI& HPB Cancer Surgeon
Hyderabad
