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Journal of Gastrointestinal Surgery

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Open Access 01-01-2022 | Multimedia Article

Autologous Posterior Rectus Sheath as a Vascularized Onlay Flap: a Novel Approach to Hiatal Hernia Repair

Authors: Yalini Vigneswaran, Ava F. Bryan, Brian Ruhle, Lawrence J. Gottlieb, John Alverdy

Published in: Journal of Gastrointestinal Surgery | Issue 1/2022

Abstract

Introduction

Complex and recurrent paraesophageal hernia repairs are a challenge for surgeons due to their high recurrence rates despite the use of various prosthetic and suturing techniques.

Methods

Here we describe the use of vascularized fascia harvested from the posterior rectus sheath with peritoneum during robotic hiatal hernia repair in two patients with large complex diaphragmatic defects.

Results

Successful harvesting and onlay of the right posterior rectus sheath based on a falciform vascular pedicle was achieved robotically by rotating and securing the flap to the diaphragmatic hiatus as an onlay flap following cruroplasty of the hiatal defect.

Conclusions

In patients with difficult to repair large paraesophageal hernias, we demonstrate a promising new technique to restore the dynamic hiatal complex with the tensile strength of autologous vascularized fascia and peritoneum.

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Title: Autologous Posterior Rectus Sheath as a Vascularized Onlay Flap: a Novel Approach to Hiatal Hernia Repair
Authors: Yalini Vigneswaran
Ava F. Bryan
Brian Ruhle
Lawrence J. Gottlieb
John Alverdy
Publication date: 01-01-2022
Publisher: Springer US
Published in: Journal of Gastrointestinal Surgery / Issue 1/2022
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-021-05134-7

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Autologous Posterior Rectus Sheath as a Vascularized Onlay Flap: a Novel Approach to Hiatal Hernia Repair

Abstract

Introduction

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusions

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