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

SAGES

Reimagining surgical care for a healthier world

  • Home
    • COVID-19 Annoucements
    • 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
    • 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
  • 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
    • Past Meetings
      • SAGES 2022
      • SAGES 2021
    • 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
    • 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
    • Video Based Assessments (VBA)
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES at Cine-Med
      • 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
  • Store
    • “Unofficial” Logo Products
  • Log In

Laparoscopic Paraesophageal Hernia with Falciform Ligament Buttress

Raymond Laird, DO, Fred Brody, MD, MBA, FACS. The George Washington University Medical Center.

Introduction: Multiple techniques have been used to decrease recurrence rates following a paraesophageal hernia repair including buttressing the crura with synthetic and biological mesh. However, synthetic mesh is associated with erosions and dysphagia while biologic buttresses are expensive and have not shown long-term decreases in recurrence rates. This study documents clinical outcomes and recurrence rates following laparoscopic paraesophageal hernia repairs using the falciform ligament as a crural buttress.
 

Methods: All patients undergoing a laparoscopic paraesophageal hernia repair from January 1, 2012 to June 30, 2013 were included in the analysis. A prospective database was created to record demographics, medications, and radiologic studies. All patients underwent an endoscopic gastroduodenoscope with either an upper gastrointestinal (GI) series or a computed tomogram (CT). Esophageal manometry and pH monitoring were selectively performed. Inclusion criteria required a hiatal defect greater than 5cm. Patients with recurrent hiatal hernias or prior gastric surgery were excluded. Operatively, all patients underwent a laparoscopic hiatal hernia repair with a Toupet fundoplication and a falciform ligament buttress. A total symptom score using a standard questionnaire to assess 9 symptoms was assessed for all patients pre- and postoperatively at 6 months. Symptoms were evaluated in terms of severity and frequency. An upper GI (UGI) series was obtained at 6 months. A paired t-test with a confidence interval of 95% was used with a p<0.05 as significant.
 

Results: 21 patients underwent laparoscopic paraesophageal hernia repair with a falciform buttress. Mean age was 65 ± 5.4 with 18 females. All procedures were completed laparoscopically with no intraoperative complications. There was no mortality and 1 patient had a seizure postoperatively. At 6 months postoperatively, the mean symptom severity score decreased from 16.7 to 3.17, the mean symptom frequency score decreased from 16.8 to 3.67, and the mean total symptom score decreased from 33.5 to 6.83. All decreases were significant at a p<0.05. All patients remain off H2 blockers or PPIs and there were no recurrences on UGI.
 

Conclusions: Early data suggests that a laparoscopic paraesophageal hernia repair using the falciform ligament as a buttress is a viable option to repair large hiatal hernias. The falciform ligament is readily available in most patients and avoids the costs of a biological mesh and the possible complications of synthetic mesh. Long-term follow up is required to verify the utility of this approach to decrease recurrence rates for paraesophageal hernias.
 

171

Share this:

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

Related

« Return to SAGES 2014 abstract archive

Hours & Info

11300 West Olympic Blvd, Suite 600
Los Angeles, CA 90064
1-310-437-0544
sagesweb@sages.org
Monday - Friday
8am to 5pm Pacific Time

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Important Links

SAGES 2023 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