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Surgical Innovation
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Laparoscopic Treatment of Large Hiatal Hernias

Miguel A. Cuesta

Department of Surgery and Gastroenterology, Academic Hospital Vrije Universiteit, Amsterdam, the Netherlands

Donald L. van der Peet

Department of Surgery and Gastroenterology, Academic Hospital Vrije Universiteit, Amsterdam, the Netherlands

Elly C. Klinkenberg-Knol

Department of Surgery and Gastroenterology, Academic Hospital Vrije Universiteit, Amsterdam, the Netherlands

Large hiatal or paraesophageal hernias constitute between 5% and 10% of all hiatal hernias. This hernia is a potential threatening complication, and a timely operative correction should be performed in all patients with an acceptable risk. Based on the lessons learned from conventional approach, laparoscopic treatment has confirmed the initial good results with all advantages of laparoscopic surgery. Reduction of the hernia, excision of the sac, and approximation of the hiatus followed by selective use of an antireflux procedure and some form of gastropexy constitute the operative steps to obtain optimal postoperative results. Copyright © 1999 by W. B. Saunders Company

Key Words: Paraesophageal hernias • laparoscopy • Nissen fundoplication.

Surgical Innovation, Vol. 6, No. 4, 213-223 (1999)
DOI: 10.1177/155335069900600405
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