Obesity Surgery

, Volume 20, Issue 6, pp 801–803 | Cite as

Treatment of Morbid Obesity and Hiatal Paraesophageal Hernia by Laparoscopic Roux-en-Y Gastric Bypass

  • Jose Luis Salvador-Sanchis
  • David Martinez-RamosEmail author
  • Ana Herfarth
  • Isabel Rivadulla-Serrano
  • Miguel Ibañez-Belenguer
  • Jane S. Hoashi
Case Report


Obesity has been proven to be a significant independent risk factor for hiatal hernia. In morbidly obese patients, the usual techniques to improve gastroesophageal reflux after hiatal hernia repair could have poorer outcomes than in the general population. Laparoscopic Roux-en-Y gastric bypass (LRYGBP) has been demonstrated to be an effective procedure in controlling symptoms and complications of gastroesophageal reflux in these patients. Therefore, LRYGBP is one of the most frequent procedures performed in bariatric surgery. The authors report a case of a 41-year-old man with a body mass index (BMI) of 44.6 kg/m2 who was diagnosed with giant type III hiatal hernia. A laparoscopic approach for both hiatal hernia repair and LRYGBP was performed. At 6 months follow-up, the patient has lost 30% of excess body weight (BMI 34.4), and there is no evidence of recurrence of the esophageal hernia.


Hiatal paraesophageal hernia Laparoscopic gastric bypass Morbid obesity 


  1. 1.
    Hampel H, Abraham NS, El-Serag HB. Meta-analysis: obesity and the risk for gastroesophageal reflux disease and its complications. Ann Intern Med. 2005;143:199–211.PubMedGoogle Scholar
  2. 2.
    Wilson LJ, Ma W, Hirschowitz BI. Association of obesity with hiatal hernia and esophagitis. Am J Gastroenterol. 1999;94:2840–4.CrossRefPubMedGoogle Scholar
  3. 3.
    Perry Y, Courcoulas AP, Fernando HC, et al. Laparoscopic Roux-en-Y gastric bypass for recalcitrant gastroesophageal reflux disease in morbid obese patients. JSLS 2004;8:19–23.PubMedGoogle Scholar
  4. 4.
    Oddsdóttir M. Paraesophageal hernia. Surg Clin North Am. 2000;80:1243–52.CrossRefPubMedGoogle Scholar
  5. 5.
    Aly A, Munt J, Jamieson GG, et al. Laparoscopic repair of large hiatal hernias. Br J Surg. 2005;92:648–53.CrossRefPubMedGoogle Scholar
  6. 6.
    Targarona EM, Bendahan G, Balague C, et al. Mesh repair of hiatal hernia: an ongoing controversy. Cir Esp. 2004;75:105–16.Google Scholar
  7. 7.
    Winslow ER, Frisella MM, Soper NJ, et al. Obesity does not adversely affect the outcome of laparoscopic antireflux surgery (LARS). Surg Endosc. 2003;17:2003–11.CrossRefPubMedGoogle Scholar
  8. 8.
    Escalona A, Devaud N, Perez G, et al. Antecolic versus retrocolic alimentary limb in laparoscopic Roux-en-Y gastric bypass: a comparative study. Surg Obes Relat Dis. 2007;3:423–7.CrossRefPubMedGoogle Scholar
  9. 9.
    Raftopoulos I, Awais O, Courcoulas AP, et al. Laparoscopic gastric bypass after antireflux surgery for the treatment of gastroesophageal reflux in morbidly obese patients: initial experience. Obes Surg. 2004;14:1373–80.CrossRefPubMedGoogle Scholar
  10. 10.
    Kendrick ML, Houghton SG. Gastroesophageal reflux disease in obese patients: the role of obesity in management. Dis Esophagus. 2006;19:57–63.CrossRefPubMedGoogle Scholar
  11. 11.
    Angrisani L, Iovino P, Lorenzo M, et al. Treatment of morbid obesity and gastroesophageal reflux with hiatal hernia by Lap-Band. Obes Surg. 1999;9:396–8.CrossRefPubMedGoogle Scholar
  12. 12.
    Landen S. Simultaneous paraesophageal hernia repair and gastric banding. Obes Surg. 2005;15:435–8.CrossRefPubMedGoogle Scholar
  13. 13.
    Weber M, Müller MK, Bucher T, et al. Laparoscopic gastric bypass is superior to laparoscopic gastric banding for treatment of morbid obesity. Ann Surg. 2004;240:975–83.CrossRefPubMedGoogle Scholar
  14. 14.
    Schauer PR, Ikramuddin S, McLaughlin RH, et al. Comparison of laparoscopic versus open repair of paraesophageal hernia. Am J Surg. 1998;176:659–65.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science + Business Media, LLC 2008

Authors and Affiliations

  • Jose Luis Salvador-Sanchis
    • 1
  • David Martinez-Ramos
    • 1
    Email author
  • Ana Herfarth
    • 1
  • Isabel Rivadulla-Serrano
    • 1
  • Miguel Ibañez-Belenguer
    • 1
  • Jane S. Hoashi
    • 1
  1. 1.Department of General and Digestive SurgeryCastellon General HospitalCastellonSpain

Personalised recommendations