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Laparoscopic Repair of Hiatal Hernia After Esophagectomy

  • Original Article
  • Published:
Journal of Gastrointestinal Surgery

Abstract

Background

Herniation of abdominal contents via the diaphragmatic hiatus is a potentially life-threatening complication of esophagectomy. Mounting evidence suggests that hiatal hernias are more common following minimally invasive esophagectomy. Therefore, post-esophagectomy hiatal hernia and its treatment bear increasing significance.

Methods

We retrospectively reviewed the records of five patients with hiatal hernia following esophagectomy over a 5-year period.

Results

Successful laparoscopic reduction of a post-esophagectomy hiatal hernia was done without mesh reinforcement in three patients. One patient underwent mesh reinforcement. One patient was found to have carcinomatosis upon laparoscopic inspection, and repair of the hiatal hernia was abandoned. There were no perioperative deaths or complications. One patient developed a recurrent hiatal hernia 14 months after repair of the initial hiatal hernia. Patients were discharged within a mean of 1.75 days after surgical repair.

Discussion

We have successfully used laparoscopy to treat hiatal hernias after esophagectomy. The benefits conferred by laparoscopy, including better visualization of the right gastroepiploic artery supplying the gastric conduit, minimally invasive evaluation of the field for metastasis, and shorter recovery time, make it our favored approach. Here, we describe our experience with hiatal hernia following esophagectomy and our operative technique.

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Conflict of interest

The authors have no conflicts of interest to disclose.

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Authors and Affiliations

  1. Division of Thoracic Surgery, Department of Surgery, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH, 03756, USA

    Cherie P. Erkmen & Vignesh Raman

  2. Section of Minimally Invasive Surgery, Department of Surgery, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH, 03756, USA

    Neil D. Ghushe & Thadeus L. Trus

Authors
  1. Cherie P. Erkmen
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  2. Vignesh Raman
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  3. Neil D. Ghushe
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  4. Thadeus L. Trus
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Corresponding author

Correspondence to Cherie P. Erkmen.

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Erkmen, C.P., Raman, V., Ghushe, N.D. et al. Laparoscopic Repair of Hiatal Hernia After Esophagectomy. J Gastrointest Surg 17, 1370–1374 (2013). https://doi.org/10.1007/s11605-013-2246-x

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  • DOI: https://doi.org/10.1007/s11605-013-2246-x

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