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Identification and Management of a “Short Esophagus” and a Complex Hiatus

  • Stephanie G. Worrell
  • Joshua A. Boys
  • Steven R. DeMeesterEmail author
Chapter

Abstract

Normally, several centimeters of the distal esophagus and the gastroesophageal junction (GEJ) lie below the hiatus within the abdomen. When the GEJ, the fundus of the stomach, or both migrate into the chest above the hiatus, a hiatal hernia is present. Intrinsic to the repair of a hiatal hernia is the need to bring the GEJ, stomach, and distal esophagus back into the abdomen. In some patients, the esophagus has shortened related to chronic reflux injury or a large hiatal hernia, and in these patients, a Collis gastroplasty can be useful to reduce tension on the repair and hopefully prevent a recurrent hernia. The original Collis gastroplasty was a transthoracic procedure, but techniques have been developed to allow a Collis gastroplasty to be done as part of a laparoscopic operation with good outcomes.

Keywords

Esophagus Hiatal hernia Paraesophageal hernia Collis gastroplasty Antireflux surgery 

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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Stephanie G. Worrell
    • 1
  • Joshua A. Boys
    • 2
  • Steven R. DeMeester
    • 2
    Email author
  1. 1.Division of Thoracic Surgery, Department of SurgeryKeck School of Medicine of the University of Southern CaliforniaLos AngelesUSA
  2. 2.Department of SurgeryUniversity of Southern CaliforniaLos AngelesUSA

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