• Skip to primary navigation
  • Skip to main content
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Advocacy
    • Strategic Plan, 2020-2023
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • SAGES Store
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
    • “Unofficial” Logo Products
  • Meetings
    • NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2024 Scientific Session Call For Abstracts
      • 2024 Emerging Technology Call For Abstracts
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • Wellness Resources – You Are Not Alone
    • OpiVoid.org
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Fellows Career Development Course
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES Top 21 MIS Procedures
    • SAGES Pearls
    • SAGES Flexible Endoscopy 101
    • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • NEW-Area of Concentrated Training Seal (ACT)-Advanced Flexible Endoscopy
    • SAGES Fellowship Certification for Advanced GI MIS and Comprehensive Flexible Endoscopy
    • Multi-Society Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • OWLS
  • Log In

Laparoscopic para-esophageal hernia repair including an anterior 180 degrees fundoplication & Mid-term outcomes in a single center

Anne-Sophie S Studer, MD, Teodoros Thomopoulos, MD, Michele Podetta, MD, Henri Atlas, MD, Ronald Denis, MD, Pierre Garneau, MD, Radu Pescarus, MD. Hopital Sacré Coeur de Montréal

Introduction: Surgical management of large paraesophageal hernias (PEH) remains challenging and may be associated with high morbidity. As an alternative to Nissen fundoplication, an anterior 180 degrees wrap has been described in the treatment of hiatal and PEH.

Materiel & Methods: Retrospective analysis of patients operated for PEH that included an anterior 180 degrees fundoplication, between October 2014 and May 2018, was performed. Pre- and post-operative clinical and objective findings (EGD, UGI study, CT abdomen or gastric emptying test) were recorded. Following laparoscopic hernia reduction and hiatal closure, the anterior gastric fundus was sutured as an anterior valve to the top of the left crus and at various locations on the right crus.

Results: Overall, 26 patients (20 Female; 6 Male), with a mean age of 70 years, underwent PEH repair with an anterior fundoplication. 12/26 (46%) patients were obese (BMI over 30 kg/m2). Pre-operative dysphagia, heartburns, epigastric pain, and regurgitations and nausea were respectively present in 65%, 65%, 58% and 35% of cases. All patients underwent primary laparoscopic PEH repair with partial anterior fundoplication, 17 patients (65%) had biological mesh reinforcement and 1 patient underwent a Collis gastroplasty. Four patients (15%) had an incarcerated PEH and underwent emergency surgery. Early post-operative morbidity rate and 30-day post-operative mortality rate were respectively 15,4% (1 post-operative confusion, 1 pneumonia, 1 angina pectoris and 1 myocardial infarction) and 0%. Median length of stay was 2 days (1-9). Median follow-up was 13 months (1-32). Anatomic hiatal hernia recurrences were diagnosed in 7 cases (27%), based on barium study (in 1 patient) or EGD (in 6 patients). Mean time of recurrence diagnosis occurred at 18,5 months. Only one patient was asymptomatic, three others complained bloating, 2 others regurgitations and nausea, and the last one, dysphagia and epigastric pain. There were 7 late complications with a mean time of occurrence of 20 months (4 oesophagitis, 2 gastroparesis, and 1 gastric ulcer). Four of those happened in a context of hiatal hernia recurrence. One patient with gastroparesis underwent a laparoscopic pyloroplasty 5 months post-op. No surgical revision was needed for the PEH recurrences.

Conclusion: Laparoscopic anterior partial fundoplication appears to be a safe option in the armamentarium of the PEH surgeon.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 94802

Program Number: P442

Presentation Session: Poster Session (Non CME)

Presentation Type: Poster

View this Poster

84

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

Hours & Info

11300 West Olympic Blvd, Suite 600
Los Angeles, CA 90064
1-310-437-0544
[email protected]
Monday - Friday
8am to 5pm Pacific Time

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Important Links

SAGES 2024 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2023 Society of American Gastrointestinal and Endoscopic Surgeons