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[Consideration regarding 20 antireflux laparoscopic operations for hiatal hernia]
I Costan1, L Alecu, Adriana Deacu
1Secţia de Chirurgie Generală, Spitalul Militar de Urgenţă Prof. Dr. Agrippa Ionescu, Sector 1, str. Arhitect Ion Mincu nr. 7, Bucureşti. iuliucos@yahoo.com
Chirurgia (Bucharest, Romania : 1990)
|March 6, 2004
Summary
Laparoscopic hiatal hernia repair offers a minimally invasive approach with good outcomes. This study of 20 patients shows reduced operative times and hospital stays, establishing it as a potential standard for gastroesophageal reflux disease (GERD).
Area of Science:
- Gastroenterology
- Minimally Invasive Surgery
- Surgical Techniques
Context:
- Hiatal hernias are a common condition often associated with gastroesophageal reflux disease (GERD).
- Laparoscopic surgery has become increasingly prevalent for abdominal procedures, offering potential benefits over open surgery.
- Evaluating the efficacy and outcomes of laparoscopic techniques for hiatal hernia repair is crucial for optimizing patient care.
Purpose:
- To assess the clinical, therapeutic, and evolutive aspects of patients undergoing laparoscopic repair for hiatal hernias.
- To analyze the types of hiatal hernias treated and the specific laparoscopic fundoplication techniques employed.
- To evaluate the safety, complications, and postoperative recovery associated with the laparoscopic approach.
Summary:
- A retrospective analysis of 20 patients with hiatal hernias (90% sliding, 10% paraesophageal) treated laparoscopically between 1999 and 2002.
- Various laparoscopic fundoplication techniques were used, including Dor, Rosetti, Toupet, and Nissen. Operative times decreased significantly with experience.
- One conversion to open surgery and three cases of bleeding (managed conservatively) were reported. No deaths occurred. Transitory dysphagia was noted in 10% of Nissen fundoplication cases.
Impact:
- Laparoscopic hiatal hernia repair demonstrates a trend towards becoming the standard of care for GERD due to its minimally invasive nature.
- This approach significantly reduces healthcare costs and yields favorable postoperative results, including shorter hospitalizations compared to open methods.
- The findings support the adoption of laparoscopic techniques for hiatal hernia management, improving patient outcomes and resource utilization.