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Laparoscopic paraesophageal hernia repair
G Perdikis1, R A Hinder, C J Filipi
1Department of Surgery, Mayo Clinic, Jacksonville, Fla, USA.
Archives of Surgery (Chicago, Ill. : 1960)
|June 1, 1997
Summary
Laparoscopic repair of paraesophageal hernias, especially type III, is a successful surgical option. This approach offers good outcomes and patient satisfaction, with antireflux procedures recommended.
Area of Science:
- Gastroenterology
- Surgical Innovation
- Minimally Invasive Surgery
Background:
- Paraesophageal hernias necessitate surgical intervention to prevent severe complications.
- Laparoscopic techniques are increasingly explored for complex abdominal conditions.
Purpose of the Study:
- To assess the efficacy and outcomes of laparoscopic repair for paraesophageal hernias.
- To evaluate the safety and success rates of the laparoscopic approach in a case series.
Main Methods:
- A case series of 65 consecutive patients undergoing laparoscopic paraesophageal hernia repair.
- Preoperative assessments included barium esophagogram, endoscopy, manometry, and 24-hour pH monitoring.
- Outcomes measured included operative complications, postoperative morbidity, and long-term symptom follow-up.
Main Results:
- The majority of hernias were type III (86%).
- Significant findings included positive 24-hour pH scores in 65% and lower esophageal sphincter incompetence in 56% of patients.
- The laparoscopic approach demonstrated a low conversion rate (3%), manageable intraoperative complications, and a short hospital stay (average 2 days).
- Long-term follow-up showed high patient satisfaction (49/53) and a low recurrence rate (7/46).
Conclusions:
- Laparoscopic repair is an effective method for managing paraesophageal hernias, particularly type III.
- Concomitant antireflux procedures are advisable.
- The laparoscopic approach yields favorable outcomes and high patient satisfaction.