Complex Laparoscopic Repair of Giant Type IV Hiatal Hernia after Esophagectomy

Fredrick Che, MD, Nojan Toomari, DO, Ninh Nguyen, MD. University of California Irvine Medical Center.

69 year old male with a history of esophageal adenocarcinoma status post laparoscopic and thoracoscopic Ivor Lewis esophagectomy, presented with abdominal pain and symptoms of bowel obstruction. Images performed showed a giant type 4 hiatal hernia with transverse and descending colon, small bowel, and omentum in the thorax. Due to the lack of improvement after non-operative management, the patient underwent extensive laparoscopic lysis of adhesions and repair of type IV hiatal hernia with mesh. Post-operatively he was able to tolerate a PO diet and was later discharged.


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