Beyond Belsey: complex laparoscopic hiatus and diaphragmatic hernia repair.


Journal

Annals of the Royal College of Surgeons of England
ISSN: 1478-7083
Titre abrégé: Ann R Coll Surg Engl
Pays: England
ID NLM: 7506860

Informations de publication

Date de publication:
Mar 2019
Historique:
pubmed: 17 10 2018
medline: 20 3 2019
entrez: 17 10 2018
Statut: ppublish

Résumé

Diaphragmatic and hiatus hernias can cause mild chronic symptoms or have an acute presentation with gastric volvulus and obstruction. Elective or emergency surgery is indicated in symptomatic patients and nowadays is generally performed laparoscopically. We report four different types of hernias: a giant hiatus hernia following a gastric pull-up for recurrent congenital diaphragmatic hernia; a Bochdalek hernia in a pregnant young woman; concomitant hiatus and Morgagni hernias; and a giant hiatus hernia occupying the right chest. All were approached laparoscopically, either electively or as an emergency. Surgery led to a resolution of symptoms in all the cases. We had no any intraoperative complications. Two patients developed minor postoperative complications (chest infection). No recurrences were found during a mean follow-up of 18 months. Transabdominal laparoscopic approach is a safe and feasible approach to all cases of symptomatic hiatus and diaphragmatic hernia.

Sections du résumé

BACKGROUND BACKGROUND
Diaphragmatic and hiatus hernias can cause mild chronic symptoms or have an acute presentation with gastric volvulus and obstruction. Elective or emergency surgery is indicated in symptomatic patients and nowadays is generally performed laparoscopically.
METHODS METHODS
We report four different types of hernias: a giant hiatus hernia following a gastric pull-up for recurrent congenital diaphragmatic hernia; a Bochdalek hernia in a pregnant young woman; concomitant hiatus and Morgagni hernias; and a giant hiatus hernia occupying the right chest. All were approached laparoscopically, either electively or as an emergency.
RESULTS RESULTS
Surgery led to a resolution of symptoms in all the cases. We had no any intraoperative complications. Two patients developed minor postoperative complications (chest infection). No recurrences were found during a mean follow-up of 18 months.
CONCLUSIONS CONCLUSIONS
Transabdominal laparoscopic approach is a safe and feasible approach to all cases of symptomatic hiatus and diaphragmatic hernia.

Identifiants

pubmed: 30322286
doi: 10.1308/rcsann.2018.0183
pmc: PMC6400907
doi:

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

162-167

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Auteurs

D Zanotti (D)

Upper Gastrointestinal Surgical Unit, Guy's and St Thomas' NHS Foundation Trust, London, UK , London , UK.

C Fiorani (C)

Upper Gastrointestinal Surgical Unit, Guy's and St Thomas' NHS Foundation Trust, London, UK , London , UK.

A Botha (A)

Upper Gastrointestinal Surgical Unit, Guy's and St Thomas' NHS Foundation Trust, London, UK , London , UK.

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Classifications MeSH