Skip to main content
SpringerLink
Log in

Education and Learning in Hiatal Hernia Repair

  • Chapter
  • First Online:
Laparo-endoscopic Hernia Surgery

  • 1109 Accesses

Abstract

Hiatal hernia (HH) commonly associated with gastroesophageal reflux disease (GERD) and its incidence is approximately 5 per 1000. About 95% of these are type I hernias of sliding variety that are not commonly associated with serious complications 7 [1]. The remaining 5% can be classified as giant paraesophageal hernias (PEHs) type 3 and 4 and are associated with significant complications 7 [2]. Our understanding of hiatal hernia has evolved over the years. Initially considered an anatomical pathology, our focus has now shifted toward the physiology of the esophagus. The appreciation of the physiological link between HH, GERD, and the related problems has caused a paradigm shift toward management of hiatal hernia. Now, we attempt to restore the physiologic function of the esophagus and lower esophageal sphincter and not just a simple repair aimed at restoring the anatomy of the lower esophageal sphincter (LES). Multiple techniques and there modifications are described in literature for repair of hiatal hernia. In the last two decades, hiatal hernia repair has undergone challenges in terms of newer approaches like tension-free repair, use of prosthetic mesh or new biomaterial, laparoscopic approach and lately NOTES, single-port laparoscopic surgery, or robotic surgery.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

References

  1. MacArthur KE. Hernias and volvulus of the gastrointestinal tract. In: Feldman M, Scharschmidt BF, Sleisenger MH, Klein S, editors. Sleisenger & Fordtran’s gastrointestinal and liver disease. Philadelphia: WB Saunders; 1998. p. 318–27.

    Google Scholar 

  2. Haas O, Rat P, Christophe M, Friedman S, Favre JP. Surgical results of intrathoracic gastric volvulus complicating hiatal hernia. Br J Surg. 1990;77:1379–81.

    Article  CAS  PubMed  Google Scholar 

  3. Wilkiemeyer M, Pappas TN, Giobbie-Hurder A, Itani KMF, Jonasson O, Neumayer LA. Does resident postgraduate year influence the outcomes of inguinal hernia repair. Ann Surg. 2005;241:879–84.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Neo EL, Zingg U, Devitt PG, et al. Learning curve for laparoscopic repair of very large hiatal hernia. Surg Endosc. 2011;25(6):1775–82.

    Article  PubMed  Google Scholar 

  5. Brown CN, Smith LT, Watson DI, et al. Outcomes for trainees vs experienced surgeons undertaking laparoscopic antireflux surgery - is equipoise achieved? J Gastrointest Surg. 2013;17(7):1173–80.

    Article  PubMed  Google Scholar 

  6. Soresi AL. Diaphragmatic hernia: its unsuspected frequency: diagnosis and technique for radical cure. Ann Surg. 1919;69:254–70.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Dallemagne B, Weerts JM, Jehaes C, et al. Laparoscopic Nissen fundoplication: preliminary report. Surg Laparosc Endosc. 1991;1(3):138–43.

    PubMed  CAS  Google Scholar 

  8. Bencini L, Moraldi L, Bartolini I, Coratti A. Esophageal surgery in minimally invasive era. World J Gastrointest Surg. 2016;8(1):52–64.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Dallemagne B, Kohnen L, Perretta S, Weerts J, Markiewicz S, Jehaes C. Laparoscopic repair of paraesophageal hernia. Long-term follow-up reveals good clinical outcome despite high radiological recurrence rate. Ann Surg. 2011;253:291–6.

    Article  PubMed  Google Scholar 

  10. Zehetner J, Demeester SR, Ayazi S, Kilday P, Augustin F, Hagen JA, Lipham JC, Sohn HJ, Demeester TR. Laparoscopic versus open repair of paraesophageal hernia: the second decade. J Am Coll Surg. 2011;212:813–20.

    Article  PubMed  Google Scholar 

  11. Ferri LE, Feldman LS, Stanbridge D, Mayrand S, Stein L, Fried GM. Should laparoscopic paraesophageal hernia repair be abandoned in favor of the open approach? Surg Endosc. 2005;19:4–8.

    Article  CAS  PubMed  Google Scholar 

  12. Zehetner J, DeMeester SR, Ayazi S, Costales JL, Augustin F, Oezcelik A, Lipham JC, Sohn HJ, Hagen JA, DeMeester TR. Long-term follow-up after anti-reflux surgery in patients with Barrett’s esophagus. J Gastrointest Surg. 2010;14:1483–91.

    Article  PubMed  Google Scholar 

  13. Petersen LF, McChesney SL, Daly SC, Millikan KW, Myers JA, Luu MB. Permanent mesh results in long-term symptom improvement and patient satisfaction without increasing adverse outcomes in hiatal hernia repair. Am J Surg. 2014;207:445–8. discussion 448.

    Article  PubMed  Google Scholar 

  14. Luketich JD, Nason KS, Christie NA, Pennathur A, Jobe BA, Landreneau RJ, et al. Outcomes after a decade of laparoscopic giant paraesophageal hernia repair. J Thorac Cardiovasc Surg. 2010;139:395–404. https://doi.org/10.1016/j.jtcvs.2009.10.005.

    Article  PubMed  Google Scholar 

  15. Le Page P, Furtado R, Hayward M, et al. Durability of giant hiatus hernia repair in 455 patients over 20 years. Ann R Coll Surg Engl. 2015;97(3):188–93.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Molena D, Mungo B, Stem M, Feinberg RL, Lidor AO. Outcomes of operations for benign foregut disease in elderly patients: a National Surgical Quality Improvement Program database analysis. Surgery. 2014;156:352–60.

    Article  PubMed  Google Scholar 

  17. Mungo B, Molena D, Stem M, Feinberg RL, Lidor AO. Thirty-day outcomes of paraesophageal hernia repair using the NSQIP database: should laparoscopy be the standard of care? J Am Coll Surg. 2014;219:229–36.

    Article  PubMed  Google Scholar 

  18. Lomanto D, Chua H, Chou P, Aung MM, Salonga MC, So JBY, Cheah WK. Use of virtual reality simulators in pre- and post-training assessment of laparoscopic surgical workshops. Oral presentation during the 8th Asia Pacific meeting of the Endoscopic and Laparoscopic Surgeons of Asia (ELSA), Hyderabad, India, August 17–19 2007.

    Google Scholar 

  19. Gilbody J, Prasthofer A, Ho K, Costa M. The use and effectiveness of cadaveric workshops in higher surgical training: a systematic review. Ann R Coll Surg Engl. 2011;93(5):347–52.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Eaton BD, Messent DO, Haywood IR. Animal cadaveric models for advanced trauma life support training. Ann R Coll Surg Engl. 1990;72(2):135–9.

    PubMed  PubMed Central  CAS  Google Scholar 

  21. Hawkins WJ, Moorthy KM, Tighe D, Yoong K, Patel RT. With adequate supervision, the grade of the operating surgeon is not a determinant of outcome for patients undergoing urgent colorectal surgery. Ann R Coll Surg Engl. 2007;89:760–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Paisley AM, Madhavan KK, Paterson-Brown S, Praseedom RK, Garden OJ. Role of the surgical trainee in upper gastrointestinal resectional surgery. Ann R Coll Surg Engl. 1999;81:40–5.

    PubMed  PubMed Central  CAS  Google Scholar 

  23. Praseedom RK, Paisley A, Madhavan KK, Garden OJ, Carter DC, Paterson-Brown S. Supervised surgical trainees can perform pancreatic resections safely. J R Coll Surg Edinb. 1999;44:16–8.

    CAS  PubMed  Google Scholar 

  24. Ahlberg G, Kruuna O, Leijonmarck CE, et al. Is the learning curve for laparoscopic fundoplication determined by the teacher or the pupil? Am J Surg. 2005;189(2):184–9.

    Article  PubMed  Google Scholar 

  25. Voitk AJ. The learning curve in laparoscopic inguinal hernia repair for the community general surgeon. Can J Surg. 1998;41:446–50.

    PubMed  PubMed Central  CAS  Google Scholar 

  26. Soot SJ, Eshraghi N, Farahmand M, Sheppard BC, Deveney CW. Transition from open to laparoscopic fundoplication : the learning curve. Arch Surg. 1999;134(3):278–81.

    Article  CAS  PubMed  Google Scholar 

  27. Watson DI, Baigrie RJ, Jamieson GGA. Learning curve for laparoscopic fundoplication. Definable, avoidable, or a waste of time? Ann Surg. 1996;224:198–203.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Deschamps C, Allen MS, Trastek VF, Johnson JO, Pairolero PC. Early experience and learning curve associated with laparoscopic Nissen fundoplication. J Thorac Cardiovasc Surg. 1998;115:281–4.

    Article  CAS  PubMed  Google Scholar 

  29. Okrainec A, Ferri LE, Feldman LS, et al. Defining the learning curve in laparoscopic paraesophageal hernia repair: a CUSUM analysis. Surg Endosc. 2011;25:1083.

    Article  PubMed  Google Scholar 

  30. Paul D P, Rachit D S, Gretchen A, et al. Comparison of early experience and learning curves associated with minimally invasive hiatus hernia repair. Poster Session presented at SAGES 2016 Annual Meeting; Mar 16–19. Boston, MA 2016.

    Google Scholar 

  31. Kubasiak J, Hood K, Daly S, et al. Improved patient outcomes in paraesophageal hernia repair using a laparoscopic approach: a study of the national surgical quality improvement program data. Am Surg. 2014;80:884–9.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, Minimally Invasive Surgical Centre, National University Health System, Singapore, Singapore

    Davide Lomanto & Hrishikesh P. Salgaonkar

Authors
  1. Davide Lomanto
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hrishikesh P. Salgaonkar
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Davide Lomanto .

Editor information

Editors and Affiliations

  1. Em.Director of Surgical Department, Marienhospital Stuttgart, Stuttgart, Germany

    Reinhard Bittner

  2. Academic Teaching Hospital of Charitè Medical School, Vivantes Hospital, Department of Surgery and Center for Minimally Invasive Surgery, Berlin, Germany

    Ferdinand Köckerling

  3. Department of General Surgery, Creighton University School of Medicine, Omaha, Nebraska, USA

    Robert J. Fitzgibbons, Jr.

  4. Louisiana State University School of Medicine, Department of Surgery, Our Lady of the Lake Physician Group, Department of Surgery, Baton Rouge, Louisiana, USA

    Karl A. LeBlanc

  5. Norton Thoracic Institute, Dignity Health, Creighton University School of Medicine (Phoenix campus), Phoenix, Arizona, USA

    Sumeet K. Mittal

  6. Minimal Access, Metabolic and Bariatric Surgery, Max Super Specialty Hospital Saket, New Delhi, India

    Pradeep Chowbey

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer-Verlag GmbH Germany, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Lomanto, D., Salgaonkar, H.P. (2018). Education and Learning in Hiatal Hernia Repair. In: Bittner, R., Köckerling, F., Fitzgibbons, Jr., R., LeBlanc, K., Mittal, S., Chowbey, P. (eds) Laparo-endoscopic Hernia Surgery. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-55493-7_45

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-55493-7_45

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-55491-3

  • Online ISBN: 978-3-662-55493-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation