[Posterior cardiopexy technique]

Area of Science:

• Gastroenterology and Surgical Procedures
• Anatomical Surgical Techniques

Context:

• Hill's posterior cardiopexy is a surgical procedure addressing gastroesophageal reflux disease (GERD).
• The technique relies on specific anatomical identification and utilization of peri-oesophageal connective tissue.
• Boutelier's description of peri-oesophageal connective tissue aligns with the anatomical structures targeted in Hill's method.

Purpose:

• To describe the anatomical basis and procedural steps of Hill's posterior cardiopexy.
• To detail the preferred surgical approach, including a left subcostal incision and fixation of the gastric fundus.
• To highlight the omission of intraoperative manometry in their preferred technique.

Summary:

• Hill's posterior cardiopexy involves closing the oesophageal hiatus and anchoring peri-oesophageal connective tissue (Hill's 'strips') to the preaortic fascia.
• The authors advocate for a left subcostal incision, foregoing intraoperative manometry.
• The procedure is completed by suturing the gastric fundus to the left of the oesophagus.

Impact:

• Provides a clear, anatomically grounded description of a specific surgical technique for GERD.
• Offers a preferred surgical methodology, potentially influencing surgical training and practice.
• Contributes to the understanding of surgical anatomy relevant to anti-reflux procedures.