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Laparoscopic gastric fundus tamponade: a novel adaptation of the Toupet fundoplication for large paraesophageal hernia repair

  • George Ferzli
  • Shinban LiuEmail author
  • Mazen Iskandar
  • Abe Fingerhut
Article
  • 31 Downloads

Abstract

Background

Laparoscopic repair of large paraesophageal hiatal hernia with defects too large to close primarily or greater than 8 cm is technically challenging. The ideal repair remains unclear and is often debated. Utilizing the gastric fundus as an autologous patch to obliterate and tamponade large hiatal defects may offer a new solution. The aim of this study was to evaluate the short-term outcomes following partial posterior fundoplication with gastric fundus tamponade.

Methods

Retrospective chart review and prospective patient follow up was conducted on patients who underwent laparoscopic hiatal hernia repair between 2015 and 2019 by a single surgeon. Basic demographics, pre-operative diagnoses, operative technique, and clinical outcomes were recorded.

Results

Fifteen patients underwent the described technique for repair of large paraesophageal hiatal hernia. All procedures were completed laparoscopically with a short post-operative length of stay (mean of 3 days) and no 30-day readmissions. The majority of patients reported resolution of their pre-operative symptoms. Only one patient required surgery for emergent indications and the same patient was the only mortality in the study, which was secondary to respiratory failure, necrotizing pneumonia, and sepsis as a result of gastric volvulus and obstruction.

Conclusion

Utilizing the gastric fundus as an autologous patch to repair large hiatal hernia may be a safe and efficacious solution with good short-term outcomes. However, further studies should be conducted to elucidate long-term results.

Keywords

Paraesophageal hernia Hiatal hernia Gastric tamponade 

Notes

Compliance with ethical standards

Disclosures

The authors George Ferzli, Shinban Liu, Mazen Iskandar, and Abe Fingerhut have no conflicts of interest or financial ties to disclose.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.General SurgeryNYU Langone HealthBrooklynUSA
  2. 2.Mount Sinai Health SystemNew York CityUSA
  3. 3.Section for Surgical Research, Department of SurgeryMedical University of GrazGrazAustria
  4. 4.Department of Gastrointestinal Surgery, Ruijin HospitalShanghai Jiao Tong University School of MedicineShanghaiChina

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