The article presents the main stages of formation of modern ideas about hiatal hernias as one of the most frequent variants of visceral anatomy’s impairment. The history of development of hiatal hearnias’ surgery is presented from the moment of its birth to the present time. According to modern ideas hiatal hernias are considered to be a chronic recurrent disease when abdominal part of esophagus, part of stomach or other internal is dislocated into a mediastenum and hernia ring is presented by esophageal hiatus. During the long time hiatal hernias were considered to be just the anatomical phenomenon. It’s known that Angello Soresi was the first American surgeon who performed an operation on hiatal hernia in 1919. A lot of original techniques of hiatal hernias’ surgery were devised in 1950. Operations developed by American surgeon – Ronald Belsey and European clinicians – Philip Allison and others became mostly widespread. During the next 10 years (1960-1970) techniques with obligatory antireflux component were offered. Most effective and popular operations which are used nowadays are ones that were developed by Rudolph Nissen, Andre Toupet, Lucius Hill and others. New stage of hiatal hernias` surgery started at 90’s of the XX century – the century of laparoscopic technologies’ wide application into clinical practice. Bernard Dallemagen performed such an operation for the first time in 1991. V.A. Kubyshkin, V.D. Fedorov and many others became the ideologists and pioneers of laparoscopic surgery of haital hernias in Russia. Application of new treatment methods and standardization of most surgical techniques permitted to increase efficiency and safety of hiatal hernias’ surgery.

OBJECTIVE. Hiatal hernias are the most common type of visceral anatomy disorder. The unresolved problem of surgical treatment of this pathology remains the high frequency of its relapse. Currently, it is believed that repeated surgical interventions for hiatal hernia are technically difficult, carry a high risk of complications and have unsatisfactory long-term results.MATERIAL AND METHODS. In the period from 2015 to 2019, 55 patients with this pathology were operated. In 52 (94.5 %) cases, the revision operation was performed laparoscopically, in 3 (5.5 %) – through left-side thoracotomy. The technique of the operation implied the removal of hiatal hernia and the implementation of antireflux reconstruction. In five (9.9 %) patients with a shortened esophagus, the fundoplication wrap was originally created in the chest; in 50 (90.1 %), normal anatomy was restored.RESULTS. Long-term results ranging from 12 to 48 months were evaluated in 53 (96.4 %) cases. The natural position of the esophagus and stomach in relation to the diaphragm was detected in 43 (81.1 %) patients, relapse of hiatal hernia – in 5 (9.4 %). In 5 patients, the fundoplication wrap formed in the chest was functional. The absence of gastroesophageal reflux was observed in 41 (91.8 % of patients who had GERD before surgery). In 4 (8.8 %) cases, including one patient with antireflux reconstruction in the chest, a relapse of the disease occurred.CONCLUSION. The presented results allowed the surgical treatment of recurrent hiatal hernias reasonable and effective.The authors declare no conflict of interest.The authors confirm that they respect the rights of the people participated in the study, including obtaining informed consent when it is necessary, and the rules of treatment of animals when they are used in the study. Author Guidelines contains the detailed information.

The objectiveof the study is to consider the main problems and to define the ways to improve the efficiency of surgical treatment of hiatal herniae.Material and methods.518 patients were operated, the plasty of hiatal hernia – posterior cruroraphy – was carried out in 191 (26.9%) of patients, the prosthetic materials via the method «mesh-reinforced» were used in 327 (63.1%) of patients.Results. The general surgical complications were noted in 43 (8.3 %) patients, the delayed side effects were in 118 (22.8 %) patients, relapse of hiatal hernia were in 27 (5.9 %) patients.Conclusion.The high frequency of relapses remains the main problem in surgery of hiatal hernia.

The most important historical stages of formation of scientific ideas of gastroesophageal reflux and its complications are presented in the article; the main milestones in the development of gastroesophageal reflux disease surgery are reflected.

The article presents modern ideas of types II-IV hiatal hernias as a variant of visceral anatomical abnormality. The latest techniques of surgical removal of hiatal hernias aimed at improving the results of surgical treatment are described in this article.