Laparoscopic surgery of esophageal hiatus hernia - single center experience.

Abstract

IntroductionEsophageal hiatal hernias are the most frequent types of internal hernias. This condition involves disturbance of normal functioning of the stomach cardiac mechanism and reflux of the gastric contents to the esophagus.Aim: To evaluate postoperative results in our Clinic and the comparison of these results to data from the literature.Material and methodsOne hundred and seventy-eight patients underwent surgery due to esophageal hiatal hernia at the Clinic of General, Gastroenterological and Oncological Surgery, Collegium Medicum, Bydgoszcz, Nicolaus Copernicus University, Torun, Poland, from 2006 to 2011. All operations were performed using laparoscopy. Fundoplication by means of the Nissen-Rossetti method was carried out in 172 patients while Toupet's and Dor's methods were applied in 4 and 2 patients, respectively.ResultsAverage time of the surgery was 82 min (55–140 min). Conversion was performed in 4 cases. No serious intraoperative complications were noted. In the postoperative period, dysphagia was reported in 20 patients (11.2%). Postoperative wound infection was observed in 1 patient (0.56%). Hernias in the trocar insertion area were reported in 3 patients (1.68%). Ailments recurred in 6 patients. The recurrence of esophageal hiatal hernia was confirmed in 2 patients. Patients with recurrent hernia were re-operated using a laparoscopic approach.ConclusionsLaparoscopic surgery is a simple and effective approach for patients with gastroesophageal reflux symptoms due to diaphragmatic esophageal hiatus hernia. The number of complications is lower after laparoscopic procedures than after “open” operations.

Dynamics of quality of life improvement after floppy Nissen fundoplication for gastroesophageal reflux disease.

“…Nissen fundoplication is a simple and effective approach for patients with gastroesophageal reflux symptoms due to diaphragmatic esophageal hiatal hernia – it should be the method of choice in patients with type III and IV hernia [ 23 , 24 ]. What is more, it is the method of choice in the treatment of Barrett's esophagus in the cases of patients who were qualified for surgery [ 25 ].…”

Thoracoscopic repair of esophageal atresia with a distal fistula - lessons from the first 10 operations.

“…Borruto et al . performed a meta-analysis comparing patients with esophageal atresia and trachea-esophageal fistula treated thoracoscopically and by thoracotomy [ 8 , 9 ]. They concluded that the outcomes using the thoracoscopic approach are similar to those with open surgery.…”

The impact of laparoscopic adrenalectomy on renal function. Results of a prospective randomised clinical trial

“…Only tumours with hormonal activity or risk of malignancy require surgical treatment [4][5][6][7]. Minimally invasive techniques are gaining acceptance in the management of many diseases, including adrenal pathologies [8][9][10]. Laparoscopic adrenalectomy is now the gold standard of surgical treatment for benign adrenal masses [11].…”