The Hill procedure
Gastroesophageal restoration (Hill operation) is accomphshed through an upper midline abdominal incision. The abdomen is explored. The pylorus is examined carefully for any evidence of pyloric stenosis that might impede gastric emptying. The triangular ligament of the left lobe of the liver is divided and the liver retracted to the patient’s right. The upper hand retractor is placed to facilitate exposure. The phrenoesophageal membrane is divided on the diaphragm removing as much of the fibroareolar tissue as possible (Fig. 1).
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