scholarly journals Laparoscopic repair of hiatal hernias: Experience after 200 consecutive cases

2014 ◽  
Vol 142 (7-8) ◽  
pp. 424-430 ◽  
Author(s):  
Milos Bjelovic ◽  
Tamara Babic ◽  
Dragan Gunjic ◽  
Milan Veselinovic ◽  
Bratislav Spica
Keyword(s):  
Minimally Invasive ◽  
Hernia Repair ◽  
Hiatal Hernia ◽  
Revisional Surgery ◽  
Cleveland Clinic ◽  
Gastric Volvulus ◽  
Hiatal Hernia Repair ◽  
Type I ◽  
Digestive Surgery ◽  
Laparoscopic Hiatal Hernia Repair

Introduction. Repair of hiatal hernias has been performed traditionally via open laparotomy or thoracotomy. Since first laparoscopic hiatal hernia repair in 1992, this method had a growing popularity and today it is the standard approach in experienced centers specialized for minimally invasive surgery. Objective. In the current study we present our experience after 200 consecutive laparoscopic hiatal hernia repairs. Methods. A retrospective cohort study included 200 patients who underwent elective laparoscopic hiatal hernia repair at the Department for Minimally Invasive Upper Digestive Surgery, Clinic for Digestive Surgery, Clinical Center of Serbia in Belgrade from April 2004 to December 2013. Results. Hiatal hernia types included 108 (54%) patients with type I, 30 (15%) with type III, 62 (31%) with giant paraesophageal hernia, while 27 (13.5%) patients presented with a chronic gastric volvulus. There were a total of 154 (77%) Nissen fundoplications. In 26 (13%) cases Nissen procedure was combined with esophageal lengthening procedure (Collis-Nissen), and in 17 (8.5%) Toupet fundoplications was performed. Primary retroesophageal crural repair was performed in 164 (82%) cases, Cleveland Clinic Foundation suture modification in 27 (13.5%), 4 (2%) patients underwent synthetic mesh hiatoplasty, 1 (0.5%) primary repair reinforced with pledgets, and 4 (2%) autologous fascia lata graft reinforcement. Poor result with anatomic and symptomatic recurrence (indication for revisional surgery) was detected in 5 patients (2.7%). Conclusion. Based on the result analysis, we found that laparoscopic hiatal hernia repair was a technically challenging but feasible technique, associated with good to excellent postoperative outcomes comparable to the best open surgery series.

scholarly journals Concomitant Laparoscopic Hiatal Hernia Repair With Cholecystectomy: A Multicentric Study

2020 ◽  
Author(s):  
paul zarogoulidis ◽  
Silviu-Daniel Preda ◽  
Sapalidis Konstantinos ◽  
Vasile Virgil Bințintan ◽  
Daniel Alin Cristian ◽  
...  
Keyword(s):  
Hernia Repair ◽  
Hiatal Hernia ◽  
Operating Time ◽  
Hiatal Hernia Repair ◽  
Type I ◽  
Multicentric Study ◽  
Type Iv ◽  
Concomitant Surgery ◽  
Laparoscopic Hiatal Hernia Repair ◽  
Feasible Option

Abstract Introduction Concomitant surgery refers to performing two or more surgical operations on one patient under the same anesthesia. Patients and Methods We performed a retrospective multicentric study from October 2016 to October 2019, analyzing patients who underwent laparoscopic hiatal hernia repair. We extracted data of patients who underwent concomitant laparoscopic surgery for both hiatal hernia repair and cholecystectomy in the following Clinics: 1st Clinic of Surgery of Craiova Emergency Clinical County Hospital, “Colțea” Hospital, 3rd Clinic of Surgery of Cluj-Napoca and 3rd Surgery Clinic of University General Hospital of Thessaloniki and identified 20 patients who underwent hiatal hernia repair and had an added cholecystectomy. Allocation of data by hiatal hernia type showed 6 type IV hernia (complex hernia), 13 type III hernias (mixed type) and 1 type I hernia (sliding hernia). Out of the 20 cases analyzed, 19 were chronic cholecystitis and one patient presented with acute cholecystitis.Average operating time was 168 minutes. Blood loss was minimum. Cruroraphy was performed in all cases, mesh reinforce was added in 5 cases, and fundoplication was added in all cases: 3 Toupet, 2 Dorr and 15 Floppy-Nissen. Fundopexy was routinely added in cases with Toupet fundoplication. Cholecystectomy was performed in the following manner: 19 retrograde, 1 bipolar. Results All patients had favorable postoperative evolution. Patient follow up was at 1 month, 3 months and 6 months, with no sign of recurrence for hiatal hernia (anatomical or symptomatic) and no postcholecystectomy syndrome. In conclusion concomitant laparoscopic hiatal hernia repair and cholecystectomy is a safe and feasible option for patients with indication of surgery for both pathologies.

scholarly journals Hiatal Hernia Repair with Gore Bio-A Tissue Reinforcement: Our Experience

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Agrusa Antonino ◽  
Romano Giorgio ◽  
Frazzetta Giuseppe ◽  
De Vita Giovanni ◽  
Di Giovanni Silvia ◽  
...  
Keyword(s):  
Hernia Repair ◽  
Hiatal Hernia ◽  
Laparoscopic Approach ◽  
Acid Reflux ◽  
Hiatal Hernia Repair ◽  
Type I ◽  
Absorbable Mesh ◽  
Laparoscopic Hiatal Hernia Repair ◽  
Crural Closure ◽  
History Of

Type I hiatal hernia is associated with gastroesophageal reflux disease (GERD) in 50–90% of cases. Several trials strongly support surgery as an effective alternative to medical therapy. Today, laparoscopic fundoplication is considered as the procedure of choice. However, primary laparoscopic hiatal hernia repair is associated with upto 42% recurrence rate. Mesh reinforcement of the crural closure decreases the recurrence but can lead to complications, above all nonabsorbable ones. We experiment a new totally absorbable mesh by Gore.Case. We present a case of a 65-year-old female patient with a 6-year classic history of GERD. Endoscopy revealed a large hiatal hernia and esophagitis. pH study was positive for acid reflux; esophageal manometry revealed LES intrathoracic dislocation. With laparoscopic approach, the hiatal hernia defect was identified and primarily repaired, by crural closure. Gore Bio-A Tissue Reinforcement was trimmed to fit the defect accommodating the esophagus. Nissen fundoplication was performed.Result. Bio-A mesh was easily placed laparoscopically. It has good handling and could be cut and tailored intraoperatively for optimal adaptation. There were no short-term complications.Conclusion. Crural closure reinforcement can be done readily with this new totally absorbable mesh replaced by soft tissue over six months. However, further data and studies are needed to evaluate long-term outcomes.

scholarly journals Concomitant Laparoscopic Hiatal Hernia Repair with Cholecystectomy: A Multicentric Study

2020 ◽  
Author(s):  
Silviu-Daniel Preda ◽  
Sapalidis Konstantinos ◽  
Paul Zarogoulidis ◽  
Vasile Virgil Bințintan ◽  
Daniel Alin Cristian ◽  
...  
Keyword(s):  
Hernia Repair ◽  
Hiatal Hernia ◽  
Operating Time ◽  
Hiatal Hernia Repair ◽  
Type I ◽  
Multicentric Study ◽  
Type Iv ◽  
Concomitant Surgery ◽  
Laparoscopic Hiatal Hernia Repair ◽  
Feasible Option

Abstract Background Concomitant surgery refers to performing two or more surgical operations on one patient under the same anesthesia. Methods We performed a retrospective multicenter study from October 2016 to October 2019, analyzing patients who underwent laparoscopic hiatal hernia repair. We extracted data of patients who underwent concomitant laparoscopic surgery for both hiatal hernia repair and cholecystectomy in the following Clinics: 1st Clinic of Surgery of Craiova Emergency Clinical County Hospital, “Colțea” Hospital, 3rd Clinic of Surgery of Cluj-Napoca and 3rd Surgery Clinic of University General Hospital of Thessaloniki and identified 20 patients who underwent hiatal hernia repair and had an added cholecystectomy. Allocation of data by hiatal hernia type showed 6 type IV hernia (complex hernia), 13 type III hernias (mixed type) and 1 type I hernia (sliding hernia). Out of the 20 cases analyzed; 19 were chronic cholecystitis and one patient presented with acute cholecystitis. Average operating time was 168 minutes. Blood loss was minimum. Cruroraphy was performed in all cases, mesh reinforcement was added in 5 cases, and fundoplication was added in all cases: 3 Toupet, 2 Dorr and 15 Floppy-Nissen. Fundopexy was routinely added in cases with Toupet fundoplication. Cholecystectomy was performed in the following manner: 19 retrograde, 1 bipolar. Results All patients had favorable postoperative hospitilisation. Patient follow up was at 1 month, 3 months and 6 months, with no sign of recurrence for hiatal hernia (anatomical or symptomatic) and no postcholecystectomy syndrome. Conclusion Concomitant laparoscopic hiatal hernia repair and cholecystectomy is a safe and feasible option for patients with indication of surgery for both pathologies.

scholarly journals Iatrogenic cardiac tamponade after laparoscopic hiatal hernia repair requiring emergency sternotomy

2018 ◽  
Vol 56 (1) ◽  
pp. 215-215 ◽  
Author(s):  
Samuel Heuts ◽  
Walther N K A van Mook ◽  
Eric J Belgers ◽  
Roberto Lorusso
Keyword(s):  
Hernia Repair ◽  
Cardiac Tamponade ◽  
Hiatal Hernia ◽  
Hiatal Hernia Repair ◽  
Laparoscopic Hiatal Hernia Repair

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.

A646 Laparoscopic Hiatal Hernia Repair With A Fundopexy In a Post Sleeve Gastrectomy Patient

2019 ◽  
Vol 15 (10) ◽  
pp. S263
Author(s):  
Vicente Cogollo ◽  
Juliana Henrique ◽  
Luis Felipe Okida ◽  
Maria Fonseca ◽  
Emanuele Lo Menzo ◽  
...  
Keyword(s):  
Sleeve Gastrectomy ◽  
Hernia Repair ◽  
Hiatal Hernia ◽  
Hiatal Hernia Repair ◽  
Laparoscopic Hiatal Hernia Repair

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.

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