Paraesophageal hiatal hernia
Example of paraesophageal hernia on Endoscopy.This is the forward and reflexed view (Retrovision maneuver)in a patient demonstrating big paraesophageal hiatal hernia.
360 Degree wrap
A 2-cm, 360 degree wrap is created using three interrupted, nonabsorbable sutures with care to avoid the anterior vagus.
Closure of the Crural Opening
The crural opening is closed with simple, interrupted nonabsorbable suture (0 Ethibond). For large defects, pledgets and/or bioprosthetic mesh may be used.
Division of Gastrohepatic Ligament
Division of gastrohepatic ligament and exposure of the right crus of the diaphragm.
