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27.09.2019 | review | Ausgabe 6/2019

European Surgery 6/2019

Giant hiatus hernia: closure of the difficult hiatus

European Surgery > Ausgabe 6/2019
MB.BS, FRACS, FACS Gregory L. Falk, MBBS (Hons) Trevor J. D’Netto, B. AVBS (Hons I) Sophia C. Little
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The online version of this article (https://​doi.​org/​10.​1007/​s10353-019-00612-4) contains supplementary material, which is available to authorized users.

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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.


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


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.


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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