Hiatal and Paraesophageal Hernia (Open and MIS Approaches)
This chapter describes the surgical procedure for repair of hiatal and paraesophageal hernia as performed by the following approaches: open and laparoscopic. The text includes an introduction that outlines the indications, risks, alternatives, essential steps, needed equipment, and variations in technique for the procedure in question. This is followed by a template operative dictation, which provides the reader with an operative report, such as is found in a patient chart or electronic medical record. A description is provided of the following critical concepts for this procedure: abdominal access, exposure of the hiatus with division of phrenoesophageal membrane, dissection of the greater curve, identification of the vagi, mediastinal dissection, crural re-approximation, with or without mesh reinforcement, fundoplication, and abdominal closure.