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Hiatal Hernia Repair in Difficult Pathologic-Anatomic Situations at the Hiatus

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Laparo-endoscopic Hernia Surgery

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Abstract

Laparoscopic fundoplication is safe and effective and currently is considered as the “gold standard” surgical treatment for GERD with a success rate of about 80–95%. Due to lack of proper definition, different criteria like relief of GERD symptoms, improvement in quality of life, avoidance of postoperative complications, and patient satisfaction were considered. Patients sometime report symptoms strongly suggesting that of recurrence but with no objective evidence of reflux by pH study. There are various mechanisms described for recurrence, transdiaphragmatic herniation of wrap being the most common mechanism after laparoscopic repair. If symptoms are not effectively managed by PPIs or affecting quality of life, redo surgery is advisable and can be completed laparoscopically with results comparable to primary surgery with little increase in risk of recurrence.

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Author information

Authors and Affiliations

  1. Minimal Access, Metabolic and Bariatric Surgery, Max Super Specialty Hospital Saket, New Delhi, India

    Pradeep Chowbey

  2. Department of Surgery, University of Utah, Salt Lake City, UT, USA

    Alice Chung MD & Ellen Morrow MD

Authors
  1. Pradeep Chowbey
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  2. Alice Chung MD
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  3. Ellen Morrow MD
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Corresponding author

Correspondence to Pradeep Chowbey .

Editor information

Editors and Affiliations

  1. Em.Director of Surgical Department, Marienhospital Stuttgart, Stuttgart, Germany

    Reinhard Bittner

  2. Academic Teaching Hospital of Charitè Medical School, Vivantes Hospital, Department of Surgery and Center for Minimally Invasive Surgery, Berlin, Germany

    Ferdinand Köckerling

  3. Department of General Surgery, Creighton University School of Medicine, Omaha, Nebraska, USA

    Robert J. Fitzgibbons, Jr.

  4. Louisiana State University School of Medicine, Department of Surgery, Our Lady of the Lake Physician Group, Department of Surgery, Baton Rouge, Louisiana, USA

    Karl A. LeBlanc

  5. Norton Thoracic Institute, Dignity Health, Creighton University School of Medicine (Phoenix campus), Phoenix, Arizona, USA

    Sumeet K. Mittal

  6. Minimal Access, Metabolic and Bariatric Surgery, Max Super Specialty Hospital Saket, New Delhi, India

    Pradeep Chowbey

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Chowbey, P., Chung, A., Morrow, E. (2018). Hiatal Hernia Repair in Difficult Pathologic-Anatomic Situations at the Hiatus. In: Bittner, R., Köckerling, F., Fitzgibbons, Jr., R., LeBlanc, K., Mittal, S., Chowbey, P. (eds) Laparo-endoscopic Hernia Surgery. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-55493-7_42

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  • DOI: https://doi.org/10.1007/978-3-662-55493-7_42

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-55491-3

  • Online ISBN: 978-3-662-55493-7

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