Peer-reviewed veterinary case report
Surgery options and outcomes for hiatal hernia in pets
By Aiolfi A et al.·2026·Department of Biomedical Sciences for Health, Italy·View original on Europe PMC →
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Original publication title: Reflections on surgery for hiatal hernia.
Plain-English summary
Hiatal hernia and gastroesophageal reflux disease (GERD) are common problems that can seriously affect a pet's quality of life. These issues happen when the barrier that prevents stomach acid from coming back up into the esophagus is weakened. To diagnose these conditions accurately, vets may need to perform several tests, including endoscopy and special imaging studies. For pets with severe or complicated cases, surgery might be recommended to fix the hernia and improve the barrier. While some surgical options are very effective at reducing reflux, they can sometimes lead to swallowing difficulties or other issues. Overall, the success of these treatments can vary, and it's important to discuss the best options with your veterinarian.
Abstract
Gastroesophageal reflux disease and hiatal hernia are highly prevalent, chronic, and heterogeneous disfunctions with a profound impact on patient's quality of life. Impairment of the antireflux barrier -which includes the lower esophageal sphincter, the gastroesophageal flap valve, and the crural diaphragm- is the main pathophysiological factor responsible for symptoms and complications. Accurate diagnosis mandates a comprehensive multidisciplinary assessment including upper endoscopy, high-resolution manometry, barium esophagram, and ambulatory pH or pH-impedance monitoring to characterize anatomical defects, motility abnormalities, and reflux severity. Well selected individuals with refractory or complicated reflux disease, and those with large hiatal hernia and intrathoracic stomach, may benefit from laparoscopic surgical management including crural repair and fundoplication to restore the antireflux barrier. Nissen fundoplication is highly effective in controlling reflux but it may be associated with postoperative dysphagia and gas-bloat syndrome. Partial fundoplication can offer comparable reflux control with reduced adverse effects, especially in patients with impaired esophageal motility. Novel devices such as the LINX and the RefluxStop show promise in augmenting the lower esophageal sphincter with favorable safety profiles. The role of mesh reinforcement for hiatal repair remains contentious due to unpredictable outcomes and risk of complications. Robotic-assisted surgery offers enhanced technical precision but has yet to demonstrate significant clinical superiority and incurs greater costs compared to laparoscopy. Artificial intelligence applications are emerging as valuable adjuncts for preoperative planning, intraoperative guidance, and postoperative monitoring, potentially improving procedural standardization and surgical outcomes.
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Search related cases →Original publication on Europe PMC: https://europepmc.org/article/MED/41430014