Guidelines for the management of hiatal hernia

Imaging the posterior mediastinum: a multimodality approach

“…In a sliding hernia, the gastroesophageal junction migrates above the diaphragm through the esophageal hiatus, whereas in a paraesophageal hernia, the stomach herniates without any displacement of the gastroesophageal junction. Sliding hernias, which account for more than 95% of cases, are often associated with gastroesophageal reflux disease (64,65). Conversely, paraesophageal hernias may present acutely with obstructive symptoms due to gastric volvulus, which may cause bleeding, incarceration, strangulation, and perforation of the stomach and intestine (64).…”

“…Conversely, paraesophageal hernias may present acutely with obstructive symptoms due to gastric volvulus, which may cause bleeding, incarceration, strangulation, and perforation of the stomach and intestine (64). The most recent guidelines suggest surgical repair of all symptomatic paraesophageal hernias and preventive repair of asymptomatic paraesophageal hernias only after a careful evaluation of patient and comorbidities (64).…”

Laparoscopic hernioplasty of hiatal hernia

“…Laparoscopic hernioplasty of hiatal hernia has been confirmed effective and safe in recent years and performed more due to its mini-invasive nature and intraperitoneal view and operating angle (1,2). However, it is still a kind of difficult surgery in the field of hernia surgery that requires a good understanding of the surrounding anatomy of the gastroesophageal junction and esophageal hiatus as well as precise operation (3).…”

Volume and outcomes relationship in laparoscopic diaphragmatic hernia repair

“…Diaphragmatic hernias represent a spectrum of disease from small asymptomatic sliding hiatal hernias to giant symptomatic paraesophageal hiatal hernias [1]. Traditionally, repair of these hernias was performed using an open approach either via a laparotomy or thoracotomy; however, laparoscopic repair has been shown to have improved perioperative outcomes and has thus become the preferred approach [1][2][3][4][5].…”

“…Traditionally, repair of these hernias was performed using an open approach either via a laparotomy or thoracotomy; however, laparoscopic repair has been shown to have improved perioperative outcomes and has thus become the preferred approach [1][2][3][4][5]. The laparoscopic approach provides superior visualization of the surgical field compared to the open technique but it is technically challenging and good outcomes are hinged on good surgical technique and the surgeon's experience [2,6].…”