Federico Serrot, MD1, Julia Samame, MD1, Matthew Apel, MD1, Hannah Loebl, MS2, Iman Ghaderi, MD1, Carlos Galvani, MD1. 1Banner University Medical Center, 2University Of Arizona, College of Medicine
Introduction: The association between scoliosis and giant paraesophageal hernia has been previously described in the literature. To date there is no standard surgical approach. This video descibes a Robotic-assisted Repair of a Giant Paraesophageal Hiatal Hernia in a Patient with Scoliosis.
Methods and Procedures: The pre operative workup included abdominal CT scan, EGD, esophageal manometry.
Results: 75 year old female with a significant past medical history of GERD and scoliosis, who presented with three destinctive episodes of intractable nausea and vomiting. After work up patient was found to have a giant Type IV paraesophageal hernia with total herniation of the stomach, partial stomach volvulus and partial herniation of the transverse colon. Due to patient's symptoms it was decided to take this patient to the operating room for a Robotic-assisted repair of the giant type IV paraesphageal hiatal hernia.
The Operative Time was 173 min, EBL 20 cc. No complications were observed. Patient was discharged home on post operative day 2.
Conclusion: Robotic trasnabdominal aproach seems an acceptable alternative in patients with giagant paraesophageal hernias and scoliosis.