Journal of Gastrointestinal Surgery

, Volume 16, Issue 7, pp 1406–1411

How I Do It: Laparoscopic Paraesophageal Hernia Repair

Authors

  • Edward D. Auyang
    • Department of SurgeryUniversity of Washington
    • Department of SurgeryUniversity of Washington
How I do it

DOI: 10.1007/s11605-012-1877-7

Cite this article as:
Auyang, E.D. & Pellegrini, C.A. J Gastrointest Surg (2012) 16: 1406. doi:10.1007/s11605-012-1877-7

Abstract

Introduction

Paraesophageal hernias are usually complex anatomic abnormalities of the upper gastrointestinal tract capable of causing symptoms and complications including death. Furthermore, they affect patients who are usually older and have other comorbidities. Preferred treatment approach has evolved over time, with laparoscopic repair being the current preferred technique as it causes less hemodynamic changes and is better tolerated than open repairs.

Technique

In this report, we describe our technique for laparoscopic paraesophageal hernia repair. The most salient technical aspects of this procedure include reduction of the stomach below the diaphragm, circumferential dissection and excision of the hernia sac, closure of the crural defect with our without the addition of mesh, and fundoplication to prevent reflux.

Conclusion

While this procedure has a low morbidity risk and short hospital stay, anatomic recurrence is frequent even when performed by experienced surgeons.

Keywords

Paraesophageal hernia repairHiatal herniaAntireflux procedureBiologic meshEsophageal lengthening

Copyright information

© The Society for Surgery of the Alimentary Tract 2012