Laparoscopic Repair of Acutely Incarcerated Paraesophageal Hernia

This is an 80 year old male who presented with acute incarceration of a known paraesophageal hernia. He was reduced by emergency endoscopy. The past history is significant for hypothyroidism and GERD, long standing. The video demostrates the amount of stomach that can necrose if this emergent condition is not operated quickly. The edema in the tissues, especially at the hernia sac/crural fiber junction, can make the dissection difficult. This is clearly demonstrated. The importance of adequate esophageal length is demonstrated, as well as why complete mobilization of the posterior attachments along with sac excision, are so important in acheiving reduction of the stomach. The proper dissection planes are demonstrated in this video. The technique of biodegradable mesh placement is shown.

Session: Podium Video Presentation

Program Number: V020

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