alexa Laparoscopic repair of paraesophageal hernia.


Journal of Medical Implants & Surgery

Author(s): Athanasakis H, Tzortzinis A, Tsiaoussis J, Vassilakis JS, Xynos E

Abstract Share this page

BACKGROUND AND STUDY AIMS: Surgical repair of paraesophageal hernia is mandatory, due to the risk of severe complications, and it can be accomplished via the laparoscopic route. This study presents the results of laparoscopic repair of paraesophageal hernia combined with anterior hemifundoplication. PATIENTS AND METHODS: During a two-year period, ten consecutive patients with paraesophageal hernia (six men, four women; mean age 73, range 55-82) underwent laparoscopic treatment. Five patients presented with symptoms of gastroesophageal reflux, while another four reported lower chest pain. There was one patient in whom the paraesophageal hernia was manifested with upper gastrointestinal bleeding. Six patients had type III hiatal hernia. They all underwent esophagography, upper gastrointestinal endoscopy, stationary manometry, and 24-hour ambulatory pH-metry, preoperatively and within three months postoperatively. At laparoscopy, the hernia content was completely reduced, the sac excised, and the diaphragmatic crura approximated. The operation was completed with an anterior hemifundoplication. In three cases, a prosthetic mesh was applied to close the hiatal defect securely. RESULTS: Operating times ranged from 75 min to 125 min (mean 90 min). There were no postoperative deaths. One patient developed atelectasis, and another had empyema of the left pleura, treated with drainage and antibiotics. All patients but one were discharged on the second or third postoperative day. At the three-month follow-up examination, none of the patients had symptoms related to the paraesophageal hernia, gastroesophageal reflux, or fundoplication. Esophagography demonstrated restoration of normal anatomy at the gastroesophageal region, while esophageal motility was improved, and esophageal pH-metry showed no gastroesophageal reflux. CONCLUSION: Laparoscopic repair of paraesophageal hernias is a safe, technically feasible, and well tolerated procedure, which offers rapid and total relief of symptoms. The addition of an anterior hemifundoplication not only cures preexisting gastroesophageal reflux, but also prevents the development of postoperative gastroesophageal reflux.

This article was published in Endoscopy and referenced in Journal of Medical Implants & Surgery

Relevant Expert PPTs

Relevant Speaker PPTs

Recommended Conferences

Relevant Topics

Peer Reviewed Journals
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

© 2008-2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version