Hiatal hernia repair at the initial laparoscopic adjustable gastric band operation reduces the need for reoperation

Abstract

Adding HHR to LAGB where indicated significantly reduces reoperation rate. Every effort should be made to detect and repair HHR during placement of the band, as it will decrease future need for reoperation.

Upper gastrointestinal investigations before gastric banding

“…The presence of a hiatal hernia also had no impact on the postoperative outcome after LAGB, and crural repair was not performed as part of the LAGB operation. This contrasts with recent reports demonstrating that hiatal hernia repair at the initial LAGB operation can reduce the number of reoperations [33].…”

Safety of the laparoscopic adjustable gastric band: 7-year data from a U.S. center of excellence

“…We noted in the former study that band slip often was associated with hiatal hernia, as diagnosed at the time of reoperation, possibly due to the loss of the epiphrenic fat pad with overall weight loss. Currently, we routinely look for and repair hiatal hernias at the initial operation with either anterior or posterior crural plication, which has been proved to decrease the reoperation rate [13].…”

Early U.S. outcomes after laparoscopic adjustable gastric banding in patients with a body mass index less than 35 kg/m2

“…No saline was left in the band intraoperatively. Hiatal hernias were actively sought and repaired with primary crural repair [10].…”