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Laparoscopic posterior cruroplasty: a patient tailored approach
A Aiolfi1, M Cavalli2, G Saino3
1Department of Biomedical Science for Health, Division of General Surgery, University of Milan, Istitituto Clinico Sant'Ambrogio, Via Luigi Giuseppe Faravelli, 16, 20149, Milan, Italy. alberto.aiolfi86@gmail.com.
Hernia : the Journal of Hernias and Abdominal Wall Surgery
|April 27, 2020
Summary
This study presents a standardized, patient-tailored laparoscopic posterior cruroplasty for hiatal hernia repair, showing safe and effective medium-term outcomes with improved quality of life. The approach enhances procedure standardization and outcome interpretation.
Area of Science:
- Minimally Invasive Surgery
- Gastrointestinal Surgery
- Surgical Technique Standardization
Background:
- Laparoscopic crural repair techniques lack standardization, relying on individual surgeon preferences.
- Varied surgical approaches exist for laparoscopic crural repair, leading to inconsistencies.
Purpose of the Study:
- To describe a standardized, "patient-tailored" approach for laparoscopic posterior cruroplasty in elective hiatal hernia repair.
- To establish a reproducible technique for laparoscopic posterior cruroplasty.
Main Methods:
- Retrospective single-center study (November 2015 - November 2019).
- Detailed description of a standardized "patient-tailored" laparoscopic posterior crural repair technique.
- Analysis of perioperative outcomes and quality of life using GERD-HRQL and SF-36 questionnaires.
Main Results:
- 141 patients underwent the procedure; 72.3% had simple suture repair, 27.7% had mesh-buttressed repair.
- Median operative time was 131 minutes, with no intraoperative complications or conversions.
- Low postoperative complication rate (4.2%), minimal recurrence (2.1%), and no mesh complications.
- Significant improvements in GERD-HRQL and SF-36 scores compared to baseline.
Conclusions:
- A standardized "patient-tailored" laparoscopic posterior cruroplasty is safe and effective in the medium term.
- The approach demonstrates promising perioperative outcomes and enhanced patient quality of life.
- This method promotes procedure reproducibility, standardization, and consistent outcome interpretation.
