PS01.068: LAPAROSCOPIC MANAGEMENT OF LARGE HIATAL HERNIA WITH SIMPLY SUTURE CLOSURE

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 68-69
Author(s):  
Xiaobin Zhang ◽  
Yifeng Sun ◽  
Zhigang Li
Keyword(s):  
Hernia Repair ◽  
Hiatal Hernia ◽  
Hiatus Hernia ◽  
Symptom Control ◽  
Hiatal Hernia Repair ◽  
Esophageal Function ◽  
Large Hiatal Hernia ◽  
Suture Closure ◽  
Large Hiatus Hernia

Abstract Background Laparoscopic approach has been demonstrated as safe and effective surgical access in approaching gastroesophageal reflux disease (GERD) and hiatal hernia repair. Several studies have proposed for repairing that hiatal hernia, especially large hiatus with mesh reinforcement. The objective of our study was to evaluate the effect of simple suture closure in management of large hiatus hernia (> 5 cm). Methods Between September 2012 to February 2018, 32 patients who underwent laparoscopic large hiatal hernia (> 5 cms hernia defect) repair by simply suture closure were included in our study. Different anti-reflux surgery was performed according to esophageal function examination. Peri-operative data and complications were retrospectively reviewed. 30-months complications and symptom control at 1 year were assessed by GERD-HRQL score and PPI use. Results 29 cases were performed completely with laparoscopy, with 3 cases with da Vinci Surgical System and 1 case through left thoracotomy. Hiatal hernia of all patients was repaired by simply suture closure, 24 cases were successfully operated with Nissen, 5 cases with, 2 cases with Dor and 1 case with Belsey Mark IV Fundoplication. At 3 months postoperatively follow-up, 94% of patients were off anti-reflux medications, abdominal pain occurred in 8.8(3 cases) of patients, mild dysphagia occurred in 1 patient, and 2 patients with severe dysphagia required dilator therapy. Two patients (5.9%) developed recurrence on routine follow up. Conclusion Our study showed simply suture closure was a feasible technique for repair large hiatus hernia. The advantages between laparoscopic mesh cruroplasty and simply suture closure for large hiatal hernia repair, randomised controlled trials are needed. Disclosure All authors have declared no conflicts of interest.

532 OUTCOME OF QUILICI’S HEPATIC SHOULDER PROCEDURE TO AUGMENT LAPAROSCOPIC HIATOPLASTY IN LARGE OR RECURRENT HIATAL HERNIA

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Johannes Zacherl ◽  
Viktoria Kertesz ◽  
Cordula Höfle ◽  
Lisa Gensthaler ◽  
Bernhard Eltschka ◽  
...  
Keyword(s):  
High Risk ◽  
Hernia Repair ◽  
Hiatal Hernia ◽  
Laparoscopic Hernia Repair ◽  
Perioperative Complications ◽  
Recurrent Hernia ◽  
Hernia Recurrence ◽  
Hiatal Hernia Repair ◽  
Laparoscopic Hiatal Hernia Repair

Abstract   Laparoscopic hiatoplasty and fundoplication is the gold standard of surgical treatment of GERD and hiatal hernia. However, the main drawback of laparoscopic hiatal hernia repair is a substantial recurrence rate. Hence, prosthetic meshs have been used to reduce the risk for recurrence. But meshs may cause major complications. As a consequence we adopted the hepatic shoulder plasty described by Quilici to augment the hiatal hernia repair in patients with a high risk for hernia recurrence. Methods Patients with large (>4 cm) axial hiatal hernia, giant paraesophageal or with recurrent hernia consecutively underwent laparoscopic hernia repair with crural sutures and hepatic shoulder plasty. A Toupet or a floppy Nissen fundoplication was added. In patients with giant paraesophageal hernia the hernia sack was resected. Perioperative complications were recorded. Follow-up comprised endoscopy and/or radiography and QoL-evaluation with the Eypasch score (GIQLI). Results Between 2012 and 2018 51 patients (mean age 71 years, 65% female) underwent Quilici’s procedure. Among them 33,3% had one or more previous hiatal hernia repair. There were no conversions. Postoperative complication rate was 7.8%. At follow-up after 2 years 6 recurrences (12%) were encountered, 4 of them were symptomatic (8%). One patient underwent reoperation due to hernia recurrence. In 84% QoL was significantly improved at follow-up. Conclusion In patients with high risk of recurrence, biological augmentation of the hiatal closure with the left lobe of the liver may be a valuable alternative to prosthetic reinforcement. We observed no complication attributable to liver lobe transposition.

scholarly journals Intrathoracic sleeve gastrectomy migration with gastric volvulus treated with laparoscopic repair and conversion to gastric bypass

2020 ◽  
Vol 2020 (8) ◽  
Author(s):  
Yahya Alwatari ◽  
Renato Roriz-Silva ◽  
Roel Bolckmans ◽  
Guilherme M Campos
Keyword(s):  
Gastric Bypass ◽  
Sleeve Gastrectomy ◽  
Hernia Repair ◽  
Hiatal Hernia ◽  
Gastric Volvulus ◽  
Hiatal Hernia Repair ◽  
Upper Endoscopy ◽  
Technical Standards ◽  
Upper Gastrointestinal

Abstract A 43 years old female with laparoscopic sleeve gastrectomy (SG) and an ‘anterior’ hiatal hernia repair 11 years ago, presented with 3 years history dysphagia and heartburn. Upper gastrointestinal barium showed an almost complete intrathoracic migration of the SG with a partial organoaxial volvulus. Upper endoscopy revealed a 10 cm hiatal hernia with grade B esophagitis. Laparoscopic revision surgery with reduction of the gastric sleeve, standard posterior hiatal hernia repair, resection of the narrowed remnant of the SG and conversion to a gastric bypass was performed. No postoperative complications occurred. The patient is asymptomatic at 2 years of follow-up. We present the technical standards for the management and discuss the suspected pathophysiology of this rare but challenging condition.

First human magnetic resonance visualisation of prosthetics for laparoscopic large hiatal hernia repair

Hernia ◽  
2015 ◽  
Vol 19 (6) ◽  
pp. 975-982 ◽  
Author(s):  
G. Köhler ◽  
L. Pallwein-Prettner ◽  
M. Lechner ◽  
G. O. Spaun ◽  
O. O. Koch ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Hernia Repair ◽  
Hiatal Hernia ◽  
Hiatal Hernia Repair ◽  
Large Hiatal Hernia

Concurrent Large Para-oesophageal Hiatal Hernia Repair and Laparoscopic Adjustable Gastric Banding: Results from 5-year Follow Up

2015 ◽  
Vol 26 (5) ◽  
pp. 1090-1096
Author(s):  
Andrew J. Long ◽  
Paul R. Burton ◽  
Cheryl P. Laurie ◽  
Margaret L. Anderson ◽  
Geoff S. Hebbard ◽  
...  
Keyword(s):  
Hernia Repair ◽  
Gastric Banding ◽  
Hiatal Hernia ◽  
Laparoscopic Adjustable Gastric Banding ◽  
Adjustable Gastric Banding ◽  
Hiatal Hernia Repair

RA06.03: SURGICAL OUTCOMES OF GIANT HIATAL HERNIA REPAIR IN PATIENTS OVER THE AGE OF 80

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 30-30
Author(s):  
Oleksandr Khoma ◽  
Miho Mugino ◽  
Gregory Falk
Keyword(s):  
Quality Of Life ◽  
Hernia Repair ◽  
Hiatal Hernia ◽  
Laparoscopic Fundoplication ◽  
Conflicts Of Interest ◽  
Hiatal Hernia Repair ◽  
Post Operative Period ◽  
Giant Hiatal Hernia

Abstract Background Patients with giant hiatal herniae are often symptomatic and have significantly reduced quality of life (QoL). Laparoscopic fundoplication is an established treatment of giant hiatal hernia. Advanced age has been previously shown to be the most significant predictor of mortality and morbidity in hiatal hernia repair. Reported outcomes of laparoscopic fundoplication in patients over the age of 80 are limited to case reports and small case series. Methods Data was extracted from a prospectively populated single surgeon database of laparoscopic fundoplication procedures between 1995 and 2014. Patients who were operated for giant HH (> 30% of stomach in the chest) that were aged 80 or older at the time of surgery were included. Quality of life (QOL) data was collected pre-operatively, in early post-operative period (within 12 months) and late post-operative period (24 months or later). QOL data included gastro-intestinal quality of life index (GIQLI), Visick score, dysphagia score and overall satisfaction with surgery. Search of Ryerson index (was conducted to establish month and year of death and calculate post-operative life expectancy. Results Inclusion criteria were met by 89 patients. Average age was 84 (80–93). The proportion of herniated stomach was 70.9% on average (range 30–100%; SD 27.25), the hiatal defect was large in all patients. There was 1 perioperative death from myocardial infarction at 30 days after surgery. There were no other major complications (Clavien-Dindo Grade III-IV). Post-operative survival was an average of 74.5 months (SD 47.8; range 1–233). GIQLI was reduced pre-operatively (mean 91.8; SD 19.4). There was improvement in GIQLI scores on early (mean 101.45; SD 21.2) and late (mean 106.7; SD 19.2; P = 0.005) post-operative follow up. Pre-operative Visick scores (mean 2.92; SD 0.98) have improved significantly in early (mean 1.94; SD 0.97; P = 0.000) and late (mean 2.03; SD 0.99; P = 0.001) post-operative periods. During early post-operative follow up 97% of the patients were satisfied with overall outcome of their operation, whilst 3% were dissatisfied. Overall satisfaction scores remained high on late follow up (93.3% satisfied, 6.7% dissatisfied). Conclusion Findings of this study demonstrate that in carefully selected patients with giant HH surgery is safe and results in improved quality of life post operatively. Disclosure All authors have declared no conflicts of interest.

Efficiency of Cruroplasty as a Treatment of Gastro-Esophageal Reflux Disease in Morbid Obese Patients with Hiatus Hernia during SleeveGastrectomy

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Alaa Abbas Sabry ◽  
Youhanna Shohdy Shafik ◽  
Ahmed Mohamed Sabry ◽  
Andrew Nasr Faris Wanees
Keyword(s):  
Sleeve Gastrectomy ◽  
Hernia Repair ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Hiatal Hernia ◽  
Hiatus Hernia ◽  
Reflux Disease ◽  
Morbidly Obese ◽  
Hiatal Hernia Repair ◽  
Obese Patients ◽  
Gerd Symptoms

Abstract Background The effect of laparoscopic sleeve gastrectomy (LSG) on gastroesophageal reflux disease (GERD) is controversial. Although concomitant hiatal hernia repair (HHR) at the time of LSG is common and advocated by many, there are few data on the outcomes of GERD symptoms in these patients. The aim of this study was to evaluate the effect of concomitant HHR on GERD symptoms in morbidly obese patients undergoing LSG. Aim of the Work To analyse the impact of hiatal hernia repair (HHR) on gastro-oesophageal reflux disease (GERD) in morbidly obese patients with hiatus hernia undergoing laparoscopic sleeve gastrectomy (LSG). Patients and Methods This is a retrospective cohart study. We collected the data of Patients who underwent lap sleeve gastrectomy with cruroplsty in the same operation in the period between July 2018 and July 2019. Results Before surgery, symptomatic GERD was present in 14 patients (70%), and HH was diagnosed In 20 patients (100%), HH was diagnosed pre-operatively. The mean follow-up was 6 months. GERD remission occurred in 18 patients (90%). In the remaining 2 patients, antireflux medications were diminished, with complete control of symptoms. HH recurrences developed in 1 patient (10%). "De novo" GERD symptoms developed in 22.9% of the patients undergoing SG alone compared with 0% of patients undergoing SG plus HHR. Conclusion SG with HHR is feasible and safe, providing good management of GERD in obese patients with reflux symptoms. Small hiatal defects could be underdiagnosed at preoperative endoscopy and/or upper gastrointestinal contrast study. Thus, a careful examination of the crura is always recommended intraoperatively.

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