The Optimal Approach to Symptomatic Paraesophageal Hernia Repair: Important Technical Considerations

Jessica A. Zaman, Anne O. Lidor

Research output: Contribution to journalReview article

Abstract

While the asymptomatic paraesophageal hernia (PEH) can be observed safely, surgery is indicated for symptomatic hernias. Laparoscopic repair is associated with decreased morbidity and mortality; however, it is associated with a higher rate of radiologic recurrence when compared with the open approach. Though a majority of patients experience good symptomatic relief from laparoscopic repair, strict adherence to good technique is critical to minimize recurrence. The fundamental steps of laparoscopic PEH repair include adequate mediastinal mobilization of the esophagus, tension-free approximation of the diaphragmatic crura, and gastric fundoplication. Collis gastroplasty, mesh reinforcement, use of relaxing incisions, and anterior gastropexy are just a few adjuncts to basic principles that can be utilized and have been widely studied in recent years. In this article, we present a comprehensive review of literature addressing key aspects and controversies regarding the optimal approach to repairing paraesophageal hernias laparoscopically.

Original languageEnglish (US)
Article number53
JournalCurrent Gastroenterology Reports
Volume18
Issue number10
DOIs
Publication statusPublished - Oct 1 2016
Externally publishedYes

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Keywords

  • Collis gastroplasty
  • Hiatal hernia
  • Recurrent paraesophageal hernia
  • Relaxing incision
  • Shortened esophagus
  • Symptomatic paraesophageal hernia

ASJC Scopus subject areas

  • Gastroenterology

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