Concurrent Laparoscopic Paraesophageal Hernia Repair with Subtotal Gastrectomy and D2 Lymphadenectomy

Carmen L Mueller, MD, Lorenzo E Ferri, MD, PHD. Montreal General Hospital, McGill University Health Centre.

 The laparoscopic, transabdominal approach has become a standard technique for paraesophageal hernia repair, and laparoscopic distal gastrectomy with D2 lymphadenectomy has been shown to have equivalent oncologic outcomes to open surgery. The concurrent existence of both surgical problems in one patient poses technical challenges for the surgeon. 

This video presents the case of an 82 year old male who underwent laparoscopic distal gastrectomy with D2 lymphadenectomy and concurrent repair or large type 3 paraesophageal hernia. The video hightlghts the technical aspects of both procedures, including port placement to accomodate both surgical goals. Detailed footage of laparoscopic D2 dissection for gastric cancer is also shown.

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