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BMC Surgery
Published in: BMC Surgery 1/2013

Open Access 01-12-2013 | Research article

The Belsey Mark IV: an operation with an enduring role in the management of complicated hiatal hernia

Authors: Charalampos Markakis, Periklis Tomos, Eleftherios D Spartalis, Pavlos Lampropoulos, Leonidas Grigorakos, Dimitrios Dimitroulis, Elias Lachanas, E Andreas Agathos

Published in: BMC Surgery | Issue 1/2013

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Abstract

Background

The Belsey Mark IV operation has been used for the management of hiatal hernia for over 40 years, but with the introduction of laparoscopic techniques its role has become questionable. To determine the current role of this procedure we present a contemporary series of patients.

Methods

We reviewed fifteen consecutive patients, mean age of 63 years, who underwent a Belsey Mark IV fundoplication for gastroesophageal reflux in the presence of a hiatal hernia in our Department from January 2005 to March 2011. Indications for the thoracic approach included paraesophageal hernias, recurrent hiatal hernias and previous upper abdominal surgery.

Results

There was no operative mortality. Immediate postoperative morbidity included 1 case of bleeding, 1 case of pneumonia and 1 case of atrial fibrillation. The mean length of stay was 5.9 days. After a mean follow-up time of 49 months, all patients reported total or partial alleviation of their symptoms. No hernia recurrence was detected during barium swallow examination.

Conclusions

The Belsey approach is a procedure that can be useful as an alternative in selected cases when there are co-morbidities complicating the transabdominal (laparoscopic) approach.
Appendix
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Metadata
Title
The Belsey Mark IV: an operation with an enduring role in the management of complicated hiatal hernia
Authors
Charalampos Markakis
Periklis Tomos
Eleftherios D Spartalis
Pavlos Lampropoulos
Leonidas Grigorakos
Dimitrios Dimitroulis
Elias Lachanas
E Andreas Agathos
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Surgery / Issue 1/2013
Electronic ISSN: 1471-2482
DOI
https://doi.org/10.1186/1471-2482-13-24

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