Possibilities of diagnosis and laparoscopic methods of treatment for hiatal hernia

Abstract

Background. Evaluating the diagnostic possibilities and results of surgical treatment in patients with hiatal hernia was objective of our study. Materials and methods. One hundred nineteen patients with hiatal hernia underwent laparoscopic surgery at the department of digestive surgery of SI “Institute of Gastroenterology of the NAMS of Ukraine” in 2013–2018. Results. Hiatal hernia type I was diagnosed in 101 (84.9 %) patients, hiatal hernia type II — in 14 (11.8 %), hiatal hernia type III — in 4 (3.4 %). Hernia cruroplasty was performed in 100 % of cases: posterior cruroplasty — in 67 (56.3 %) patients, anterior and posterior (сombined) — in 36 (30.3 %), alloplasty and cruroplasty — in 16 (13.4 %). We used the following options of laparoscopic fundoplication in patients with hiatal hernia: Nissen fundoplication — in 96 (80.7 %) cases, Toupet fundoplication — in 12 (10.1 %), Dor fundoplication — in 11 (9.2 %). Fixing the cuff to the diaphragm crus were performed in 87 (73.1 %) patients. There were no lethal cases after surgery. Conclusions. Results of the study indicate the efficacy of laparoscopic surgery in hiatal hernia, which was well tolerated by patients and characterized by a small percentage of complications, allow you to recognize them as operations of choice in the treatment of this pathology.

Keywords

• hiatal hernia
• gastroesophageal reflux disease
• laparoscopic fundoplication