Hiatal Surgery Service Recommendations

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A Hiatal Surgical Service is defined as investigation, assessment and surgery for the treatment of gastro-oesophageal reflux, symptomatic hiatus hernia and achalasia. It should have multi-disciplinary involvement andn well defined structure including specialist surgeons, access to GI physiology, radiology, gastroenterology, specialist nutritional support and specialist nurse support.

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Performance guidelines

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• perform a minimum unit volume of > 50 hiatal cases per year (unit definition - a department within a hospital OR a collaboration of hospitals within a close geographical region)

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• perform a minimum individual surgeon volume > 10 cases per surgeon per year

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• Surgical units offering hiatal surgery must provide 7 day a week cover for specialist hiatal surgical care (management of complications and emergencies) or a formal agreement for specialist advice or transfer if required to an adjacent unit that does.