Concomitant Laparoscopic Hiatal Hernia Repair with Cholecystectomy: A Multicentric Study

Abstract

Background Concomitant surgery refers to performing two or more surgical operations on one patient under the same anesthesia. Methods We performed a retrospective multicenter study from October 2016 to October 2019, analyzing patients who underwent laparoscopic hiatal hernia repair. We extracted data of patients who underwent concomitant laparoscopic surgery for both hiatal hernia repair and cholecystectomy in the following Clinics: 1st Clinic of Surgery of Craiova Emergency Clinical County Hospital, “Colțea” Hospital, 3rd Clinic of Surgery of Cluj-Napoca and 3rd Surgery Clinic of University General Hospital of Thessaloniki and identified 20 patients who underwent hiatal hernia repair and had an added cholecystectomy. Allocation of data by hiatal hernia type showed 6 type IV hernia (complex hernia), 13 type III hernias (mixed type) and 1 type I hernia (sliding hernia). Out of the 20 cases analyzed; 19 were chronic cholecystitis and one patient presented with acute cholecystitis. Average operating time was 168 minutes. Blood loss was minimum. Cruroraphy was performed in all cases, mesh reinforcement was added in 5 cases, and fundoplication was added in all cases: 3 Toupet, 2 Dorr and 15 Floppy-Nissen. Fundopexy was routinely added in cases with Toupet fundoplication. Cholecystectomy was performed in the following manner: 19 retrograde, 1 bipolar. Results All patients had favorable postoperative hospitilisation. Patient follow up was at 1 month, 3 months and 6 months, with no sign of recurrence for hiatal hernia (anatomical or symptomatic) and no postcholecystectomy syndrome. Conclusion Concomitant laparoscopic hiatal hernia repair and cholecystectomy is a safe and feasible option for patients with indication of surgery for both pathologies.