Minimally Invasive Repair Of Hiatal Hernia After Esophagectomy.
Daniela Molena, Arianna Barbetta, MD, David R. Jones, MD.
Memorial Sloan Kettering Cancer Center, New York, NY, USA.
OBJECTIVE: Hiatal hernia after esophagectomy has been a known but rare complication likely due to the opening of the diaphragmatic hiatus to improve exposure to the mediastinal dissection of the esophagus and to allow the conduit transposition to the chest or neck. Since the introduction of minimally invasive techniques an increased incidence of this complication has been seen with a quite high morbidity rate after repair1.
METHODS: In this video we show the technique for a successful repair of such conditions.
RESULTS: The main steps of the procedure are:-Reduction of the hernia in the abdomen-Straightening of the gastric conduit-Closure of the hiatus-Fixation of the conduit to the crus
CONCLUSIONS: In our experience a transabdominal minimally invasive approach is preferred in most cases and a transthoracic exposure is rarely needed.
1. Oor JE, Wiezer MJ, Hazebroek EJ. Hiatal Hernia After Open versus Minimally Invasive Esophagectomy: A Systematic Review and Meta-analysis. Ann Surg Oncol. 2016 Aug;23(8):2690-8
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