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Published in: Journal of Gastrointestinal Surgery 8/2008

01-08-2008 | how i do it

Laparoscopic Repair of a Giant Hiatus Hernia—How I Do It

Authors: Bas P. L. Wijnhoven, David I. Watson

Published in: Journal of Gastrointestinal Surgery | Issue 8/2008

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Abstract

The laparoscopic approach is now the technique of choice for the repair of large hiatus hernia. It is associated with a low risk of complications. However, controversy exists as to the optimal technique for laparoscopic repair. In this paper, we describe our approach. This entails full dissection of the hernia sac from the mediastinum, hiatal repair with posteriorly placed sutures, and then construction of an appropriate fundoplication. Whether the use of mesh for hiatal repair will reduce the risk of subsequent reintervention and not add any new risks is, however, unclear. For this reason, we believe that the mesh should only be used in appropriately designed clinical trials, and for now, the standard approach to laparoscopic repair of a large hiatus hernia is sutured repair.
Literature
1.
go back to reference Stylopoulos N, Rattner DW. The history of hiatal hernia surgery: from Bowditch to laparoscopy. Ann Surg 2005;241(1):185–193.PubMed Stylopoulos N, Rattner DW. The history of hiatal hernia surgery: from Bowditch to laparoscopy. Ann Surg 2005;241(1):185–193.PubMed
2.
go back to reference Krysztopik RJ, Jamieson GG, Devitt PG, Watson DI. A further modification of fundoplication. 90 degrees anterior fundoplication. Surg Endosc 2002;16(10):1446–1451.PubMedCrossRef Krysztopik RJ, Jamieson GG, Devitt PG, Watson DI. A further modification of fundoplication. 90 degrees anterior fundoplication. Surg Endosc 2002;16(10):1446–1451.PubMedCrossRef
3.
go back to reference Watson DI, Liu JF, Devitt PG, Game PA, Jamieson GG. Outcome of laparoscopic anterior 180-degree partial fundoplication for gastroesophageal reflux disease. J Gastrointest Surg 2000;4(5):486–492.PubMedCrossRef Watson DI, Liu JF, Devitt PG, Game PA, Jamieson GG. Outcome of laparoscopic anterior 180-degree partial fundoplication for gastroesophageal reflux disease. J Gastrointest Surg 2000;4(5):486–492.PubMedCrossRef
4.
go back to reference Jamieson GG, Watson DI, Britten-Jones R, Mitchell PC, Anvari M. Laparoscopic Nissen fundoplication. Ann Surg 1994;220(2):137–145.PubMedCrossRef Jamieson GG, Watson DI, Britten-Jones R, Mitchell PC, Anvari M. Laparoscopic Nissen fundoplication. Ann Surg 1994;220(2):137–145.PubMedCrossRef
5.
go back to reference Catarci M, Gentileschi P, Papi C, Carrara A, Marrese R, Gaspari AL, Grassi GB. Evidence-based appraisal of antireflux fundoplication. Ann Surg 2004;239(3):325–337.PubMedCrossRef Catarci M, Gentileschi P, Papi C, Carrara A, Marrese R, Gaspari AL, Grassi GB. Evidence-based appraisal of antireflux fundoplication. Ann Surg 2004;239(3):325–337.PubMedCrossRef
6.
go back to reference Aly A, Munt J, Jamieson GG, Ludemann R, Devitt PG, Watson DI. Laparoscopic repair of large hiatal hernias. Br J Surg 2005;92(5):648–653.PubMedCrossRef Aly A, Munt J, Jamieson GG, Ludemann R, Devitt PG, Watson DI. Laparoscopic repair of large hiatal hernias. Br J Surg 2005;92(5):648–653.PubMedCrossRef
7.
go back to reference Watson DI, Davies N, Devitt PG, Jamieson GG. Importance of dissection of the hernial sac in laparoscopic surgery for large hiatal hernias. Arch Surg 1999;134(10):1069–1073.PubMedCrossRef Watson DI, Davies N, Devitt PG, Jamieson GG. Importance of dissection of the hernial sac in laparoscopic surgery for large hiatal hernias. Arch Surg 1999;134(10):1069–1073.PubMedCrossRef
8.
go back to reference Donkervoort SC, Bais JE, Rijnhart-de Jong H, Gooszen HG. Impact of anatomical wrap position on the outcome of Nissen fundoplication. Br J Surg 2003;90(7):854–859.PubMedCrossRef Donkervoort SC, Bais JE, Rijnhart-de Jong H, Gooszen HG. Impact of anatomical wrap position on the outcome of Nissen fundoplication. Br J Surg 2003;90(7):854–859.PubMedCrossRef
9.
go back to reference Pierre AF, Luketich JD, Fernando HC, Christie NA, Buenaventura PO, Litle VR, Schauer PR. Results of laparoscopic repair of giant paraesophageal hernias: 200 consecutive patients. Ann Thorac Surg 2002;74(6):1909–1915. discussion 1915–1906.PubMedCrossRef Pierre AF, Luketich JD, Fernando HC, Christie NA, Buenaventura PO, Litle VR, Schauer PR. Results of laparoscopic repair of giant paraesophageal hernias: 200 consecutive patients. Ann Thorac Surg 2002;74(6):1909–1915. discussion 1915–1906.PubMedCrossRef
10.
go back to reference Parameswaran R, Ali A, Velmurugan S, Adjepong SE, Sigurdsson A. Laparoscopic repair of large paraesophageal hiatus hernia: quality of life and durability. Surg Endosc 2006;20(8):1221–1224.PubMedCrossRef Parameswaran R, Ali A, Velmurugan S, Adjepong SE, Sigurdsson A. Laparoscopic repair of large paraesophageal hiatus hernia: quality of life and durability. Surg Endosc 2006;20(8):1221–1224.PubMedCrossRef
11.
go back to reference Frantzides CT, Madan AK, Carlson MA, Stavropoulos GP. A prospective, randomized trial of laparoscopic polytetrafluoroethylene (PTFE) patch repair vs simple cruroplasty for large hiatal hernia. Arch Surg 2002;137(6):649–652.PubMedCrossRef Frantzides CT, Madan AK, Carlson MA, Stavropoulos GP. A prospective, randomized trial of laparoscopic polytetrafluoroethylene (PTFE) patch repair vs simple cruroplasty for large hiatal hernia. Arch Surg 2002;137(6):649–652.PubMedCrossRef
12.
go back to reference Granderath FA, Schweiger UM, Kamolz T, Asche KU, Pointner R. Laparoscopic Nissen fundoplication with prosthetic hiatal closure reduces postoperative intrathoracic wrap herniation: preliminary results of a prospective randomized functional and clinical study. Arch Surg 2005;140(1):40–48.PubMedCrossRef Granderath FA, Schweiger UM, Kamolz T, Asche KU, Pointner R. Laparoscopic Nissen fundoplication with prosthetic hiatal closure reduces postoperative intrathoracic wrap herniation: preliminary results of a prospective randomized functional and clinical study. Arch Surg 2005;140(1):40–48.PubMedCrossRef
13.
go back to reference Oelschlager BK, Pellegrini CA, Hunter J, Soper N, Brunt M, Sheppard B, Jobe B, Polissar N, Mitsumori L, Nelson J, Swanstrom L. Biologic prosthesis reduces recurrence after laparoscopic paraesophageal hernia repair: a multicenter, prospective, randomized trial. Ann Surg 2006;244(4):481–490.PubMed Oelschlager BK, Pellegrini CA, Hunter J, Soper N, Brunt M, Sheppard B, Jobe B, Polissar N, Mitsumori L, Nelson J, Swanstrom L. Biologic prosthesis reduces recurrence after laparoscopic paraesophageal hernia repair: a multicenter, prospective, randomized trial. Ann Surg 2006;244(4):481–490.PubMed
Metadata
Title
Laparoscopic Repair of a Giant Hiatus Hernia—How I Do It
Authors
Bas P. L. Wijnhoven
David I. Watson
Publication date
01-08-2008
Publisher
Springer-Verlag
Published in
Journal of Gastrointestinal Surgery / Issue 8/2008
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-008-0473-3

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