Affiliation:
1. General Surgery, Université Catholic de Louvain, Louvain-la-Neuve, Belgium
2. General Surgery, Europe Hospitals, Brussels, Belgium
Abstract
Introduction: Giant hiatal hernia represents 0.3–15% of all hiatal hernia. Its complication such as the strangulation of the stomach are life-threatening. Therefore, in most of the cases it must be surgically handled.
Case Report: We report the case of a 74-year-old patient with giant hiatal hernia. He presented with sub-acute symptoms (e.g., vomiting, appetite loss, and hematemesis). Considering the symptomatology and complementary tests, we decided to perform a laparoscopic hernia repair using mesh reinforcement. We provided a commented operative video to describe the surgical procedure. We then discussed the surgical technique and decided how to conduct a safe and efficient repair.
Conclusion: A surgical approach is the recommended treatment in most giant hiatal hernia due to its life-threatening complications. The technique should be tailored to the patient. Although there is no consensus whether to use a mesh reinforcement, we believed that a cautious mesh placement should be considered when the crura are of poor quality. Surgeons should also be cautious with the fundoplicature and the risk of stricture, therefore we propose the systematic use of a tube to test the passage in the esophago-gastric junction.
Publisher
Edorium Journals Pvt. Ltd.
Subject
General Medicine,General Earth and Planetary Sciences,General Environmental Science,Psychiatry and Mental health,Pharmacology (medical),General Medicine,General Medicine,General Medicine,General Engineering,General Medicine,Management of Technology and Innovation