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Laparoscopic Repair of Paraesophageal Hiatus Hernia: Suture Cruroplasty or Prosthetic Repair

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Hiatal Hernia Surgery

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Abstract

Since the introduction of laparoscopic antireflux surgery in 1991, the repair of very large paraesophageal hiatal hernias (PHH), encountered in approximately 50% of laparoscopic antireflux surgical practice, seem to pose a challenging predicament for surgeons. In the chronic setting there is debate about indications for surgery and what is the best operative approach. The issue of which technique i.e. laparoscopic, robotic, transthoracic or transabdominal produces better surgical outcomes for these large hiatal hernia remains contentious. Furthermore, there also remains a debate regarding the best way to close the crural pillars of these large hiatal hernias i.e. either using sutures (tension producing) or mesh (tensionless). This is because the dehiscence of crural repair may lead to intrathoracic migration of the wrap, recurrence of reflux and/or dysphagia requiring difficult revisional surgery. The current chapter will address an area of controversy i.e. the use of prosthetic material (mesh) at the esophageal hiatus and whenever possible will compare it to suture cruroplasty based on up-to-date clinical literature. The objective of the following discussion is to discuss the clinical outcomes, safety and effectiveness and complications of the two commonly used methods for elective surgical repair of large hiatal hernias.

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Author information

Authors and Affiliations

  1. Department of General Surgery, Logan Hospital, Meadowbrook, Brisbane, QLD, Australia

    Manjunath Siddaiah-Subramanya M.B.B.S., M.R.C.S., F.R.A.C.S.

  2. South East Queensland Surgery (SEQS) and Sunnybank Obesity Centre, Suite 9, McCullough Centre, 259 McCullough Street, Sunnybank, QLD, Australia

    Breda Memon R.N., L.L.B., P.G.C.Ed. & Muhammed Ashraf Memon M.B.B.S., F.A.C.S., F.R.A.C.S.

  3. Mayne Medical School, School of Medicine, University of Queensland, Brisbane, QLD, Australia

    Muhammed Ashraf Memon M.B.B.S., F.A.C.S., F.R.A.C.S.

  4. Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia

    Muhammed Ashraf Memon M.B.B.S., F.A.C.S., F.R.A.C.S.

  5. Faculty of Health and Social Science, Bolton University, Bolton, Lancashire, UK

    Muhammed Ashraf Memon M.B.B.S., F.A.C.S., F.R.A.C.S.

  6. School of Agricultural, Computing and Environmental Sciences, International Centre for Applied Climate Sciences and Centre for Health Sciences Research, University of Southern Queensland, Toowoomba, QLD, Australia

    Muhammed Ashraf Memon M.B.B.S., F.A.C.S., F.R.A.C.S.

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  1. Manjunath Siddaiah-Subramanya M.B.B.S., M.R.C.S., F.R.A.C.S.
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  2. Breda Memon R.N., L.L.B., P.G.C.Ed.
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  3. Muhammed Ashraf Memon M.B.B.S., F.A.C.S., F.R.A.C.S.
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Correspondence to Muhammed Ashraf Memon M.B.B.S., F.A.C.S., F.R.A.C.S. .

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  1. Faculty of Health Sciences and Medicine, University of Southern Queensland Faculty of Health Sciences and Medicine, Toowoomba, Queensland, Australia

    Muhammed Ashraf Memon

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Siddaiah-Subramanya, M., Memon, B., Memon, M.A. (2018). Laparoscopic Repair of Paraesophageal Hiatus Hernia: Suture Cruroplasty or Prosthetic Repair. In: Memon, M. (eds) Hiatal Hernia Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-64003-7_9

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  • DOI: https://doi.org/10.1007/978-3-319-64003-7_9

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