Toe Amputation Vs Hiatus Hernia Repair

PIG Meeting: 8th April 2021

78-year-old lady for amputation of 4 toes due to valgus deformity


  • Long-standing valgus deformity of toes, limiting ability to wear shoes
  • Wheelchair-bound following complex ankle surgery on other foot
  • Hiatus hernia with significant symptoms including daily nausea and vomiting, waterbrash and a hoarse voice


  • Hiatus hernia repair scheduled for 4 weeks after foot surgery
  • Patient very keen to proceed with both procedures as scheduled


  • Likely safer to defer foot surgery until after hernia repair
  • Patient is aware of risks and if wants to proceed then that is reasonable
  • Neuraxial anaesthesia is an option


  • Discuss with general surgeon as they may not feel that timing of the foot surgery gives adequate recovery time before hernia repair