The experience of surgical treatment of hiatal hernia with laparoscopic access

Abstract

Background. Diagnosis and treatment of hiatal hernia — one of the most pressing problems of modern medicine. The objective of the study is to present the experience of surgical treatment of hiatal hernia with laparoscopic access. Materials and methods. 67 patients with hiatal hernia underwent surgical treatment with laparoscopic access in the department of digestive of SI “Institute of Gastroenterology of the NAMS of Ukraine” for the period of 2013–2017. Results. Hiatal hernia type I was diagnosed in 60 (88.2 %) patients, hiatal hernia type II — in 7 (10.4 %) patients, mixed hiatal hernia with short esophagus — in 1 (1.5 %) patient. Hernia cruroplasty was performed in 100 % patients with hiatal hernia: posterior cruroplasty — in 60 (89.6 %) patients, anterior cruroplasty — in 2 (2.9 %) patients, сombined cruroplasty — in 5 (7.5 %) patients, alloplasty with cruroplasty — in 6 (8.9 %) patients. We used the following options of laparoscopic fundoplication in patients with hiatal hernia: Nissen fundoplication — in 46 (68.7 %), Dor fundoplication — in 7 (10.4 %) patients, Toupet fundoplication — in 14 (20.9 %) patients. Fixing the cuff to the diaphragm crus were performed in 61 (91.0 %) patients. Deaths after surgery were not registered. Conclusions. The results of the study indicate the high efficacy of laparoscopic access in the surgical treatment of patients with hiatal hernia.

Keywords

• hiatal hernia
• gastroesophageal reflux disease
• laparoscopic fundoplication