The Belsey Mark IV: an operation with an enduring role in the management of complicated hiatal hernia

Markakis, Charalampos; Tomos, Periklis; Spartalis, Eleftherios; Lampropoulos, Pavlos; Grigorakos, Leonidas; Dimitroulis, Dimitrios; Lachanas, Elias; Agathos, E. Andreas

doi:10.1186/1471-2482-13-24

Cited by 13 publications

(8 citation statements)

References 19 publications

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“…Surgery seems to be more difficult in elderly patients [ 85 ], but we consider laparoscopy as feasible in emergency [ 86 – 89 ]. It is a secure technique in both young and elderly patients [ 90 – 96 ] and in repair of wound defects. The constant improvement of open and laparoscopic surgical procedures [ 97 – 104 ] and diagnostic techniques [ 105 – 118 ] have allowed a significant development in the field of wall defects.…”

Section: Discussionmentioning

confidence: 99%

Self-gripping mesh versus fibrin glue fixation in laparoscopic inguinal hernia repair: a randomized prospective clinical trial in young and elderly patients

et al. 2016

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AbstractLaparoscopic transabdominal preperitoneal inguinal hernia repair is a safe and effective technique. In this study we tested the hypothesis that self-gripping mesh used with the laparoscopic approach is comparable to polypropylene mesh in terms of perioperative complications, against a lower overall cost of the procedure.We carried out a prospective randomized trial comparing a group of 30 patients who underwent laparoscopic inguinal hernia repair with self-gripping mesh versus a group of 30 patients who received polypropylene mesh with fibrin glue fixation.There were no statistically significant differences between the two groups with regard to intraoperative variables, early or late intraoperative complications, chronic pain or recurrence.Self-gripping mesh in transabdominal hernia repair was found to be a valid alternative to polypropylene mesh in terms of complications, recurrence and postoperative pain. The cost analysis and comparability of outcomes support the preferential use of self-gripping mesh.

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Section: Discussionmentioning

confidence: 99%

Self-gripping mesh versus fibrin glue fixation in laparoscopic inguinal hernia repair: a randomized prospective clinical trial in young and elderly patients

et al. 2016

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“…Belsey Mark IV: This method has been the gold standard before the advent of laparoscopy [21]. It is a partial anterior wrap, though left 5th intercostal space postero-lateral thoracotomy.…”

Section: Specific Anti-reflux Surgeriesmentioning

confidence: 99%

Updates on Management of GERD Disease

Iannetti¹

2017

J Gastrointest Dig Syst

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Gastro-esophageal reflux disease is a very common disease. Natural history provides an alternative to wellness and reactivating the disease. The purpose of this article is to review the condition of gastroesophageal reflux disease. The article discusses the diagnostic methods, the clinical presentations and the higher incidence of atypical forms and high reflux symptoms. Many patients are not responding to therapy and those who respond to drugs become dependent on the cure. Medical therapy has some adverse events such as anemia, osteoporosis, and infections. Physiotherapy can be an alternative treatment that offers a temporal benefit.Surgical therapy is performed with laparoscopy, which is less invasive than open procedure and reduces the time of stay. Endoscopic surgery is devoid of postoperative complications and is easily executable. It can be carried out with one day residency. The article outlines the various endoscopic techniques of recent years and reports scientific studies. From these it appears that the efficacy of endoscopic therapies for the treatment of GERD has not been documented with certainty. So, despite the dream of resolving gastroesophageal reflux with mini-invasive or, even better, endoscopic surgical procedures, the experience of real life teaches us that the medical therapy is effective in most cases and risk free, if the patient is followed closely.

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“…The Belsey Mark IV operation (BMIV) was introduced into clinical practice more than 55 years ago and has been historically performed via an open transthoracic approach. 1,2 The operation involves mobilization of gastric fundus via left thoracotomy with application of mattress sutures to create a 240° anterior wrap. 3,4 Success after this operation has been reported to exceed 85%.…”

Section: Introductionmentioning

confidence: 99%

“…3,4 Success after this operation has been reported to exceed 85%. 1 Evolving surgical technology with the development of laparoscopic surgery has reduced the need for open transthoracic approaches. Refinement of minimally invasive transabdominal hiatal hernia repair has demonstrated excellent outcomes while eliminating the morbidity associated with thoracotomy incisions.…”

Section: Introductionmentioning

confidence: 99%

Robotic Belsey Mark IV Repair of the Paraesophageal Hernia

Reza

Bakhos

et al. 2023

Innovations�(Phila)

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Objective: Surgical repair of paraesophageal hernias in patients with hostile abdomen is challenging. Despite its utility as an open procedure, the adoption of the minimally invasive Belsey Mark IV procedure has been limited because of the complexity of using traditional video-assisted thoracoscopic instrumentation. The robotic platform offers additional degrees of freedom, which enables minimally invasive transthoracic approach despite challenging anatomy. The purpose of this article is to describe a technique of robotic approach for the Belsey Mark IV operation. Methods: We retrospectively reviewed 5 cases of the robotic Belsey Mark IV procedure completed at a single institution between June 2018 and November 2021. Data were collected from a review of the medical records, including operative reports, anesthesia records, imaging, and clinical notes. The operative technique is described in the present article. There were 4 men and 1 woman. The average age of the patients was 64.4 ± 13.6 years, with an average body mass index of 24.5 kg/m2. Three patients had undergone previous transabdominal hiatal hernia repair, and 2 of them had 2 prior repairs. One patient underwent simultaneous pulmonary left lower lobectomy for cancer with the Belsey Mark IV procedure. Results: The average operative time was 209 ± 95 min (110 to 360 min). The average postoperative length of stay was 4.2 days, and 2 patients experienced complications including bleeding and persistent air leak (after lobectomy). The average blood loss was 67 ± 25 mL. Conclusions: The robotic platform enables a transthoracic minimally invasive approach to the Belsey Mark IV operation.

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The Belsey Mark IV: an operation with an enduring role in the management of complicated hiatal hernia

Cited by 13 publications

References 19 publications

Self-gripping mesh versus fibrin glue fixation in laparoscopic inguinal hernia repair: a randomized prospective clinical trial in young and elderly patients

Self-gripping mesh versus fibrin glue fixation in laparoscopic inguinal hernia repair: a randomized prospective clinical trial in young and elderly patients

Updates on Management of GERD Disease

Robotic Belsey Mark IV Repair of the Paraesophageal Hernia

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