Laparoscopic Hiatal Hernia Repair during in-Sleeve Gastrectomy

Abstract

Obesity is one of the most important health problems in developed and developing countries. Morbid obesity is defined as having a body mass index (BMI) of more than 40 kg/m2. Obesity does not only predispose to gastroesophageal reflux, but is also an important independent risk factor for the development of hiatal hernia (HH). There are articles advocating about half of obese patients have a hiatal hernia. Hiatal hernia not only exacerbates reflux symptoms, but may also lead to incomplete removal of the gastric fundus during laparoscopic sleeve gastrectomy (LSG). When hiatal hernias are seen preoperatively or intraoperatively for bariatric surgery, surgical correction should ideally be made with mesh reinforcement to prevent further clinical progression.

Case Report: Acute Intrathoracic Sleeve Migration with Partial Volvulus after Laparoscopic Sleeve Gastrectomy and Hiatal Hernia Repair

“…Surgical intervention is necessary to prevent gastric ischemia and other complications associated with ITSM. [1][2][3][4][5][6][7][8][9][10][11]…”

“…This report presents a case of acute incarcerated hiatal hernia with partial volvulus due to ITSM in a patient who underwent concomitant hiatal hernia repair with LSG. [1][2][3][4][5][6][7][8][9][10][11]…”

Acute Intrathoracic Migration With Incarceration of Laparoscopic Sleeve Gastrectomy Due to Incomplete Hiatal Hernia Repair

“…Hiatoplasty or cardiopexy with the help of ligamentum teres hepatis is a technique that has been recently suggested [ 6 , 13 ]. Mesh reinforcement with hiatoplasty can be performed in selected patients [ 14 ]. Although all these techniques are interesting, their long-term results are still unknown and their routine use removes the most attractive feature of LSG, its technical simplicity [ 5 ].…”