Victoria Lyo, MD, Thomas Knowles, Yalini Vigneswaran, James Dolan, MD, Andrea Stroud, Stephanie Wood. OHSU
This is a case series of two rare, para-hiatal hernias of different magnitude. Both para-hiatal hernia repairs were performed in the same week at our tertiary care, referral hospital.
Our first patient had an elective laparoscopic sleeve gastrectomy, and was incidentally found to have a small hernia adjacent to the hiatus with incarcerated omentum. This was simply repaired with three 0-Ticron sutures.
Our 2nd patient is a 42-year-old man with a longstanding history of well-controlled of acid reflux on omeprazole, with a more acute onset 5-month history of constant nausea and intermittent vomiting. Preoperatively, an endoscopy revealed a medium-sized paraesophageal hernia. An esophagram showed gastric folds above the diaphragm alongside a normally positioned GEJ, consistent with a type 2 PEH and no gastroesophageal reflux. He had a normal gastric emptying study. He incidentally had a CT coronary calcium study, which showed a small hiatal hernia.
In this video, we explain and show the repair of a para-hiatal hernia with felt pledgeted 0-Ticron sutures, as well as a primary hiatal hernia repair in the same patient. A Nissen fundoplication was performed for her gastroesophageal reflux as well. A completion endoscopy was performed, which showed a nice, Hill grade 1 valve. Post-operatively, he was doing well with complete resolution of his reflux and nausea.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 94913
Program Number: V098
Presentation Session: Exhibit Hall Theater Video Session IV
Presentation Type: EHVideo