Jeffrey R Watkins, MD, Ralph W Aye, MD, Alexander S Farivar, MD, Brian E Louie, MD. Swedish Medical Center
Video Introduction – One of the largest issues facing modern foregut surgery is the high rate of recurrence after paraesophageal hernia repair. Multiple studies have shown an unacceptably high rate of failure after surgical repair, regardless of the technique utilized. A new laparoscopic technique incorporating a Nissen fundoplication and placement of Hill posterior gastropexy sutures was implemented at our institution.
The Nissen-Hill Hybrid repair addresses the main weakness of each individual repair, namely the high rate of Nissen herniation and loosening of the anchor sutures in the Hill repair. The Hill sutures fix the gastroesophageal junction to the pre-aortic fascia while the Nissen maintains circumferential integrity and keeps the Hill sutures from loosening. Studies looking at the Nissen-Hill Hybrid repair have returned promising results including low anatomical recurrence rates, high quality of life satisfaction scores and low reoperation rates.
We advocate the use of the laparoscopic Nissen-Hill Hybrid technique in the repair of paraesophageal hernias. We present this video as an introduction to the technique and offer a look into how we perform the operation.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 79394
Program Number: V078
Presentation Session: Foregut 2
Presentation Type: Video
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