Large paraesophageal hernia in elderly patients: Two case reports of laparoscopic posterior cruroplasty and anterior gastropexy

Moussa, Wissam G. El Hajj; Rizk, Simon; Assaker, Nidal; Makhoul, Elias; Chelala, E.

doi:10.1016/j.ijscr.2019.10.047

Cited by 3 publications

(2 citation statements)

References 19 publications

(19 reference statements)

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“…However, the principles of surgical hernia reduction and repair have evolved, and laparoscopic anterior gastropexy has more recently been considered by some authors to have a role as the primary procedure in the treatment of GERD or hernia complications, as in patients with significant comorbidities,5 6 or even in some paediatric groups 7. Some authors may also see advantages of this additional technique when trying to minimise recurrence rates, when compared with the potential complications associated with mesh hiatoplasty.…”

Section: Discussionmentioning

confidence: 99%

Gastrocutaneous fistula and gastrointestinal bleeding due to left superior epigastric artery haemorrhage as a rare complication of anterior gastropexy

2022

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A woman in her 70s was referred to our institution with upper gastrointestinal (GI) bleeding 3 months after a Toupet fundoplication with anterior gastropexy, performed due to gastro-oesophageal reflux disease and a large paraoesophageal hernia. Clinical investigation revealed two ulcers, with one of them at the gastropexy site. A couple of weeks later, the patient presented with a gastrocutaneous fistula. Failure of conservative and endoscopic treatment of the fistula and GI bleeding demanded surgical treatment. The gastropexy tissue was excised and bleeding from the left superior epigastric artery, involved at the ulcerated gastropexy site, was identified; a definitive surgical repair was performed at a second stage. This is an extremely rare complication of anterior gastropexy and bleeding from the gastropexy site, especially when refractory to endoscopic treatment, should raise suspicion for involvement of superior left epigastric artery. The timing of the definitive surgical repair might be of major relevance.

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Section: Discussionmentioning

confidence: 99%

Gastrocutaneous fistula and gastrointestinal bleeding due to left superior epigastric artery haemorrhage as a rare complication of anterior gastropexy

2022

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“…Laparoscopic anterior gastropexy has been described for the treatment of symptomatic hiatal hernias, especially in high operative risk patients such as the elderly comorbid population (16,17). This minimal invasive approach, with division of the gastrocolic ligament to reduce upward pulling force on the greater curvature, is safe and achieves good short-term results (18).…”

Section: Discussionmentioning

confidence: 99%

Repair of an iatrogenic posterolateral diaphragmatic hernia after pedicled omentoplasty for chronic empyema in an immunocompromised patient: taking down the omentum or not?—A case report

Donck¹,

Cappelle²,

Decaluwé³

et al. 2021

Curr Chall Thorac Surg

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Iatrogenic diaphragmatic hernias (IDHs) are rare, but the incidence is potentially rising due to the increased implementation of laparoscopy. In case of complications i.e. perforation, bleeding, and/or incarceration, urgent exploration is mandated. However, treatment algorithms lack. We present a case of a 49-year old immunocompromised male patient who developed an IDH with gastric herniation 1 year after performing a pedicled thoracic omentoplasty in the treatment of a recurrent pleurocutaneous fistula. An emergency laparoscopy with 3-trocar approach was performed and the stomach could successfully be reduced.In order to preserve the existing omentoplasty a gastropexy was performed to cover the large diaphragmatic defect (5 cm × 5 cm). Though, due to persisting postural pain, laparoscopic reintervention with detachment of the gastropexy and omentoplasty took place 6 weeks postoperatively. Diaphragmatic repair was executed using a polypropylene mesh. Further postoperative course was uneventful. One year postoperatively neither chronic pain nor signs of hernia recurrence or empyema are noted. In the repair of IDH caused by a pedicled omentoplasty a laparoscopic approach with mesh repair might be preferred considering previous thoracic surgery and/or infections, overview of the abdominal cavity and diaphragm, and visualization of the pedicle.Nevertheless, the need to preserve the omentoplasty in immunocompromised and other patients should be further investigated, as repair after detachment is technically less complex.

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Laparoscopic Anterior Gastropexy for Giant Hiatal Hernia

Takii

Takemura

Tada

et al. 2022

Jpn J Gastroenterol Surg

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Large paraesophageal hernia in elderly patients: Two case reports of laparoscopic posterior cruroplasty and anterior gastropexy

Cited by 3 publications

References 19 publications

Gastrocutaneous fistula and gastrointestinal bleeding due to left superior epigastric artery haemorrhage as a rare complication of anterior gastropexy

Gastrocutaneous fistula and gastrointestinal bleeding due to left superior epigastric artery haemorrhage as a rare complication of anterior gastropexy

Repair of an iatrogenic posterolateral diaphragmatic hernia after pedicled omentoplasty for chronic empyema in an immunocompromised patient: taking down the omentum or not?—A case report

Laparoscopic Anterior Gastropexy for Giant Hiatal Hernia

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