What is the operative strategy of a paraesophageal hernia repair? The key steps of paraesophageal hernia repair are: Return stomach and esophagus to their normal intraabdominal positions. Remove the hernia sac. Close the hiatus. Anchor the stomach below the diaphragm. In most circumstances, a fundoplication is added both to augment the LES and to aid …
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What are the indications for surgical repair of paraesophageal hernias? In most patients with a paraesophageal hernia, it is the hernia itself that is responsible for symptoms and imparts the risk of life-threatening complications. There is no medical medication appropriate for treating a paraesophageal hernia. The only therapy for the hernia is surgical, and there …
How are hiatal and paraesophageal hernias diagnosed and evaluated? Paraesophageal hernias are often first suspected because of a chest radiograph abnormality. Classically a retrocardiac air bubble with or without an air-fluid level will be present. Confirmation can be obtained with a barium swallow, which shows the typical appearance of a large intrathoracic stomach and evaluates the motility of the …
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What are the signs and symptoms of a paraesophageal hernia? Many hiatal hernias are asymptomatic and are first recognized on chest radiography. Type I is often associated with reflux but does not cause direct symptoms. Paraesophageal hernias classically cause symptoms of substernal chest pain, often thought to be cardiac in origin, and shortness of breath …
four types of hernias occurring at the hiatus Type I is a sliding hiatal hernia in which the GE junction migrates through the hiatus into the posterior mediastinum as a result of laxity of the phrenoesophageal ligament. This is the most common type of hiatal hernia (95%). Type II is a true paraesophageal hernia, characterized by an upward dislocation …
What causes a hiatal hernia? The precise cause of a hiatal hernia is unknown. Its pathogenesis is thought to involve at least two important factors, including increased intraabdominal pressure and a progressive enlargement of the diaphragmatic hiatus. The increased incidence with age suggests that these hernias are acquired.
What are the complications of laparoscopic fundoplication? A laparoscopic antireflux operation is associated with significantly reduced postoperative pain, shorter hospitalization, quicker recovery, and improved cosmesis when compared with the open approach. The overall incidence of complications after laparoscopic Nissen fundoplication is between 2% and 13%. Most complications are minor and include urinary retention, postoperative gastric …