Laparoscopic Paraesophageal Hernia Repair

Perdikis, Galen; Hinder, Ronald A.; Filipi, Charles J.; Walenz, Tammara; McBride, Pamela; Smith, Stephen L.; Katada, Natsuya; Klingler, Paul J.

doi:10.1001/archsurg.1997.01430300028005

Cited by 138 publications

(78 citation statements)

References 10 publications

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“…Lengthening procedures did not seem necessary for any patient in our experience, and the low incidence of recurrent herniation in the series tends to confirm the efficacy of our approach. Perdikis et al 15 report similar outcomes from a series of 65 laparoscopic repairs of paraesophageal hiatal hernias. Lengthening procedures were not performed for any of their patients.…”

Section: Commentmentioning

confidence: 79%

Importance of Dissection of the Hernial Sac in Laparoscopic Surgery for Large Hiatal Hernias

Watson

Davies²,

Devitt³

et al. 1999

Arch Surg

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Section: Commentmentioning

confidence: 79%

Importance of Dissection of the Hernial Sac in Laparoscopic Surgery for Large Hiatal Hernias

Watson

Davies²,

Devitt³

et al. 1999

Arch Surg

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“…However, with the popularization of laparoscopic antireflux surgery for gastroesophageal reflux disease (GERD), the laparoscopic approach has been widely reported [2, 3, 4, 5, 6, 7, 8, 9, 10, 11]. Most of these reports focus on the technical success of completing the repair laparoscopically, perioperative complications, and short-term recurrence rates.…”

Section: Introductionmentioning

confidence: 99%

Surgical Management of Paraesophageal Hernias: Outcome and Quality of Life Analysis / with Invited Commentary

Velanovich

Karmy‐Jones²

2001

Dig Surg

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Background: Paraesophageal hernias (PEHs) have protean clinical manifestations, and a variety of surgical approaches may be appropriate. We report both surgical and quality-of-life (QoL) outcomes for PEH repairs. Methods: All patients undergoing elective repair of PEHs were evaluated preoperatively for symptoms and the radiologic appearance of the PEH. In addition, patients undergoing elective repair completed the SF-36, a generic QoL instrument, preoperatively and postoperatively. Short-term postoperative complications were recorded. Symptomatic outcomes and QoL outcomes were assessed. Results: Over a 50-month period, 44 PEH repairs were completed. 3 patients represented emergently – 2 with gastric ischemia, 1 with frank gastric necrosis. The most common presenting symptoms were heartburn (48%), chest pain (27%), abdominal pain (20%), regurgitation (20%), dysphagia (18%), and microcytic anemia (18%). Only 4 patients (9%) were truly asymptomatic. 31 repairs were attempted laparoscopically, 5 were converted to open procedures. There were no gastric or esophageal perforations. 91% of patients had resolution of preoperative symptoms. The only death was in a patient with gastric necrosis. 5 of 8 patients treated by crural repair without fundoplication developed postoperative heartburn. Patients treated laparoscopically had superior QoL scores than patients treated by open surgery in the domains of physical functioning (90 vs. 65), role-physical (100 vs. 0), role-emotional (100 vs. 66.7), vitality (80 vs. 55), and social functioning (100 vs. 75). However, there were 3 symptomatic recurrences in the laparoscopic group (11.5%), all in patients with large, type-III hiatal hernias. Conclusions: PEH is a potentially life-threatening disease. Although most can be repaired laparoscopically, specific principles must be individualized to each patient to minimize complications and recurrences. A fundoplication should be added to all repairs. Laparoscopic repairs can produce superior QoL results: however, patients with large, type-III hernias may not be appropriate candidates for laparoscopic repair.

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“…There have also been a small number of such cases in Western countries [9][10][11] , and the incidence of upside down stomach is reported to be 6.2% of all esophageal hiatus hernia cases 2) . A total of only 58 cases, including the present one, of upside down stomach has also been reported in Japan 3,12,13) .…”

Section: Discussionmentioning

confidence: 99%

“…However, the chronic type is often not associated with these symptoms 1,2) . Computed tomography is a simple and useful tool to diagnose gastric volvulus.…”

Section: Discussionmentioning

confidence: 99%

“…Mild sliding esophageal hiatus hernia is frequently encountered while so-called "upside down stomach", or volvulus of the stomach prolapsing into the mediastinum, is rare [1][2][3][4][5][6][7][8] . We encountered a patient of adReceived: June 19, 2013/Accepted: July 10, 2013 Correspondence to: Takeshi Shimakawa Department of Surgery, Tokyo Womenʼs Medical University Medical Center East, 2-1-10 Nishiogu Arakawa-ku, Tokyo 116-8567, Japan vanced age who developed a large esophageal hiatus hernia with an upside down stomach, which was surgically treated.…”

Section: Introductionmentioning

confidence: 99%

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A Surgical Case of a Large Esophageal Hiatus Hernia with an Upside Down Stomach in a Patient of Advanced Age

Shimakawa

Asaka

Usuda

et al. 2013

JJCS

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Cases of so-called "upside down stomach", or volvulus of the stomach prolapsing into the mediastinum, are rare. We encountered a patient of advanced age who developed a large esophageal hiatus hernia with an upside down stomach, which was surgically treated. An 89-year-old female patient had repeated vomiting and hematemesis requiring emergency hospital admission. Upper gastrointestinal contrast study revealed severe esophageal hiatus hernia and gastric volvulus resulting in the stomach turning upside down. Computed tomography showed prolapse of the large portion of the stomach into the mediastinum. Because the patient had undergone epigastric laparotomy, surgery was initiated with opening the upper abdomen followed by returning the stomach into the peritoneal cavity. The hiatus hernia was sutured, and floppy Nissen fundoplication was performed as well as stomach fixation under the diaphragm. The patientʼs food intake was favorable postoperatively, and she was discharged.

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Laparoscopic Paraesophageal Hernia Repair

Abstract: Most paraesophageal hernias are type III. A concomitant antireflux procedure is recommended. Paraesophageal hernias can be managed successfully by the laparoscopic route with good outcome.

Cited by 138 publications

References 10 publications

Importance of Dissection of the Hernial Sac in Laparoscopic Surgery for Large Hiatal Hernias

Importance of Dissection of the Hernial Sac in Laparoscopic Surgery for Large Hiatal Hernias

Surgical Management of Paraesophageal Hernias: Outcome and Quality of Life Analysis / with Invited Commentary

A Surgical Case of a Large Esophageal Hiatus Hernia with an Upside Down Stomach in a Patient of Advanced Age

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