Laparoscopic repair of paraesophageal hernia - New access, old technique

M. Oddsdottir, A. L. Franco, W. S. Laycock, J. P. Waring, John Hunter

Research output: Contribution to journalArticle

68 Citations (Scopus)

Abstract

Large paraesophageal hernias are generally repaired by reduction of the stomach into the abdomen, sac excision, crural closure, and gastropexy or fundoplication. After gaining experience performing laparoscopic repair of sliding hiatal hernias and Nissen fundoplication we combined laparoscopic access with traditional surgical technique in treating patients with complex paraesophageal hernias. Ten adults, six males and four females, with type III paraesophageal hernias underwent laparoscopic repair between February 1993 and April 1994. The average age of the patients was 60.4 years (range 38-81). Using five ports (three 10 mm and two 5 mm), the stomach was reduced into the abdomen, the hernia sac was resected, and the defect was closed with pledgeted horizontal mattress sutures. In addition, nine patients had a Nissen fundoplication performed and one patient had a diaphragmatic gastropexy. The procedure was completed laparoscopically in all ten cases and the median operating time was 282 min (range 165-430). Two complications occurred, an intraoperative gastric laceration, and a postoperative mediastinal seroma. All patients were discharged on the 2nd or 3rd postoperative day. Eight of nine patients were asymptomatic at last follow-up (mean 8.9 months postop). One patient has mild dysphagia and heartburn from partial migration of the fundoplication into the chest. One patient died 3 months postoperatively of unrelated causes. Paraesophageal hernia can be reduced and repaired safely with laparoscopic access using standard surgical techniques.

Original languageEnglish (US)
Pages (from-to)164-168
Number of pages5
JournalSurgical Endoscopy and Other Interventional Techniques
Volume9
Issue number2
DOIs
StatePublished - Feb 1995
Externally publishedYes

Fingerprint

Hiatal Hernia
Fundoplication
Gastropexy
Stomach
Abdomen
Seroma
Heartburn
Lacerations
Intraoperative Complications
Deglutition Disorders
Hernia
Sutures
Leg
Thorax

Keywords

  • Nissen fundoplication
  • Paraesophageal hernia
  • Sliding hiatal hernia

ASJC Scopus subject areas

  • Surgery

Cite this

Laparoscopic repair of paraesophageal hernia - New access, old technique. / Oddsdottir, M.; Franco, A. L.; Laycock, W. S.; Waring, J. P.; Hunter, John.

In: Surgical Endoscopy and Other Interventional Techniques, Vol. 9, No. 2, 02.1995, p. 164-168.

Research output: Contribution to journalArticle

Oddsdottir, M. ; Franco, A. L. ; Laycock, W. S. ; Waring, J. P. ; Hunter, John. / Laparoscopic repair of paraesophageal hernia - New access, old technique. In: Surgical Endoscopy and Other Interventional Techniques. 1995 ; Vol. 9, No. 2. pp. 164-168.
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