Hiatal Hernia Surgery

An 82-year-old female patient presented with complaints of dyspnea and increasing palpitations caused by food reflux. There was no risk factor except hypertension. On physical examination, the heart rate was 120 beats/min and arrhythmic and blood pressure was 130/80 mmHg. Electrocardiography showed high-rate atrial fibrillation. Laboratory parameters were unremarkable. Echocardiography illustrated a hyperechogenic and well-circumscribed mass, 40×55 mm size, in the posterior left atrium (Figure 1, Video 1). The mass size increased with breathing and the Valsalva maneuver. There was no pathology on chest radiography. The atrial fibrillation returned to sinus rhythm spontaneously, but paroxysmal atrial fibrillation attacks were observed, which were related to food reflux at follow-up. Subsequently, cardiac computed tomography, performed to determine the etiology, failed to demonstrate any pathological findings involving the left atrium. However, there was a sliding hernia in the paraesophageal region compressing the left atrium from the inferior-posterior region (Figure 2). Hiatal hernia surgery was recommended on account of the intermittently repeating symptoms. The patient refused the operation, and she is under follow-up with medical treatment.

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Redo Hiatal Hernia Surgery: Robotic Laparoscopic Approach

Robotic Surgery ◽

10.1007/978-3-030-53594-0_51 ◽

2021 ◽

pp. 659-664

Author(s):

Alexander Christiaan Mertens ◽

Ivo A. M. J. Broeders

Keyword(s):

Hiatal Hernia ◽

Laparoscopic Approach ◽

Hernia Surgery

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Robotic-assisted hiatal hernia surgery with the da Vinci system: A 2-year experience in a single institution

Apollo Medicine ◽

10.1016/j.apme.2015.05.015 ◽

2015 ◽

Vol 12 (2) ◽

pp. 112-114

Author(s):

Arun Prasad ◽

Ramesh Kumar Aggarwal ◽

Abhishek Tiwari ◽

Vachan S. Hukkeri

Keyword(s):

Hiatal Hernia ◽

Da Vinci ◽

Single Institution ◽

Hernia Surgery ◽

Robotic Assisted ◽

Da Vinci System ◽

Vinci System ◽

System A

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Erratum to: Hiatal Hernia Surgery

Hiatal Hernia Surgery ◽

10.1007/978-3-319-64003-7_20 ◽

2018 ◽

pp. E1-E1

Author(s):

Muhammed Ashraf Memon

Keyword(s):

Hiatal Hernia ◽

Hernia Surgery

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O-EGS01 Emergency Giant Hiatal Hernia Repairs: Experiences in fundoplication versus gastropexy

British Journal of Surgery ◽

10.1093/bjs/znab429.015 ◽

2021 ◽

Vol 108 (Supplement_9) ◽

Author(s):

Mohamed Alasmar ◽

Iona McKechnie ◽

Ram Chaparala

Keyword(s):

Hiatal Hernia ◽

Emergency Surgery ◽

Conclusive Evidence ◽

P Value ◽

Hernia Surgery ◽

Post Discharge ◽

Recurrence Rates ◽

Symptomatic Recurrence ◽

Repeat Operation ◽

Giant Hiatal Hernia

Abstract Background An emergency presentation with a hiatal hernia tends to be life-threatening with a high associated mortality rate. Operative management aims to reduce the herniated stomach, dissect the hernial sac and reapproximate the crura. This will often be followed by a fundoplication or a gastropexy to reduce the risk of recurrence. This study compares the recurrence rates between patients who underwent fundoplication and gastropexy. Methods Over 8 years, from October 2012 to November 2020, 80 patients were admitted to a tertiary oesophagogastric centre requiring emergency surgery to repair a giant hiatal hernia. We conducted a retrospective review and analysis of their admission and follow-up. The primary outcome measure was acute and post-discharge symptomatic recurrence of hiatal hernia, and secondary outcomes were patient mortality and readmission rate. Results Of the 80 patients requiring emergency hiatal hernia surgery, 38% had fundoplication procedures, 53% had gastropexy, and 3% had both (n = 30, 42, 2 respectively). One patient had neither, and 6% (n = 5) patients had a complete or partial resection of the stomach due to necrosis, so they were not suitable for gastropexy or fundoplication. Eight patients (10%) had symptomatic recurrence of hiatal hernia requiring a repeat operation; three within the index admission, five post-discharge. 50% had undergone fundoplication, 38% underwent gastropexy and 13% underwent a resection (n = 4, 3, 1)(p-value=0.5). 19% (n = 15) patients were readmitted. Post-operative mortality was 6% (n = 5). Conclusions Emergency surgery for giant hiatal hernias is usually complex, and a significant cohort of these patients are elderly with significant co-morbidities. Nevertheless, there is no conclusive evidence in the literature favouring fundoplication versus gastropexy. Choice of technique is influenced by the surgeon’s experience and perioperative factors that influence the duration of the operation. This review, which includes the largest cohort of patients available in the literature, demonstrates that surgical technique does not influence the symptomatic recurrence rate in our patient group.

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Risk Factors for Readmissions and Reoperations after Hiatal Hernia Surgery: NSQIP Analysis

Journal of the American College of Surgeons ◽

10.1016/j.jamcollsurg.2019.08.1063 ◽

2019 ◽

Vol 229 (4) ◽

pp. e126

Author(s):

Andrew Broda ◽

Zachary Sanford ◽

Adam S. Weltz ◽

Udai S. Sibia ◽

Adrian Park

Keyword(s):

Risk Factors ◽

Hiatal Hernia ◽

Hernia Surgery

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Morbidity and mortality in complex robot-assisted hiatal hernia surgery: 7-year experience in a high-volume center

Surgical Endoscopy ◽

10.1007/s00464-018-6494-4 ◽

2018 ◽

Vol 33 (7) ◽

pp. 2152-2161 ◽

Cited By ~ 6

Author(s):

Alexander C. Mertens ◽

Rob C. Tolboom ◽

Hana Zavrtanik ◽

Werner A. Draaisma ◽

Ivo A. M. J. Broeders

Keyword(s):

Hiatal Hernia ◽

High Volume ◽

Morbidity And Mortality ◽

Robot Assisted ◽

Hernia Surgery ◽

High Volume Center

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