Use of the Falciform Ligament Flap for Closure of the Esophageal Hiatus in Giant Paraesophageal Hernia

Adrian E. Park, C. Marius Hoogerboord, Erica Sutton

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: Laparoscopic repair of a giant paraesophageal hiatal hernia remains a challenging procedure. Several techniques have been developed in efforts to achieve tension-free reconstruction of the esophageal hiatus. In this report, we describe a technique whereby the falciform ligament is used as an autologous onlay flap to achieve tension-free closure of the crural defect of a giant paraesophageal hernia (GPEH). Discussion: Use of the falciform ligament as a vascularized autologous onlay flap is a safe and effective procedure to obtain closure of the crural defect of a GPEH. The falciform ligament should be adequately mobilized from the anterior abdominal wall to prevent lateral tension on the flap, but care must be taken to avoid devascularization. Interrupted vertical mattress sutures are used to fix the falciform ligament to the left and right hiatal crurae.

Original languageEnglish (US)
Pages (from-to)1417-1421
Number of pages5
JournalJournal of Gastrointestinal Surgery
Volume16
Issue number7
DOIs
StatePublished - Jul 1 2012
Externally publishedYes

Keywords

  • Biological mesh
  • Education
  • Esophageal hiatus
  • Falciform ligament flap
  • Laparoscopic
  • Mesh
  • Paraesophageal hernia
  • Posterior hiatoplasty
  • Vascularized autologous onlay flap

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

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