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27.09.2019 | review

Giant hiatus hernia: closure of the difficult hiatus

Zeitschrift:
European Surgery
Autoren:
MB.BS, FRACS, FACS Gregory L. Falk, MBBS (Hons) Trevor J. D’Netto, B. AVBS (Hons I) Sophia C. Little
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s10353-019-00612-4) contains supplementary material, which is available to authorized users.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Summary

Background

Repair of the large hiatus hernia has been troubled by diaphragmatic hiatal repair failure and recurrence. Use of mesh repair may reduce recurrence at a cost of increased reoperative complications and mesh fistulation. Methods of hiatal closure facilitation are described.

Methods

Techniques and accompanying intra-surgery pictures are discussed here based on personal experience from within a service performing variable 100 giant hernia repairs annually.

Results

Techniques for closure of a large hiatus without mesh repair are described with illustration, the purpose to expose various techniques utilized in a service performing more than 100 giant hernia repairs annually.

Conclusion

Techniques adopted and described in this article may facilitate both mesh and non-mesh repair of crural hiatal defects associated with giant hiatus hernia.

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Zusatzmaterial
Video figure-of-eight suture left diaphragmatic recruitment taken during hiatus repaire. Video was taken using Stryker video camera
Literatur
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