Laparoscopic Management of Hiatal Hernias in Difficult Cases

Laparoscopic Management of Hiatal Hernias in Difficult Cases

presented by Oscar M Crespin, MD at the SAGES 2014 Meeting; Panel – Concurrent Session SS2 V012

Oscar M Crespin, MD, Brant K Oelschlager, MD, Carlos A Pellegrini, MD; University of Washington Medical Center

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Points of interest:
goals of PEH repair–13 sec
3 difficult cases–19 sec
case 1–29 sec
case 1 follow up–1:37
case 2–1:48
Type III hiatal hernia–2:01
manometry–2:17
case 2 procedure begin

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Keyword(s): 52 Fr Bougie, 60 mm stapler, ABD cavity, ABD wall, absorbable mesh, adhesions, angulating, anterior suture, antireflux valve, antrum, aspiration pneumonias, asymptomatic, Barretts esophagus, buttress, cardia, chest, chronic aspiration, chronic progressive gastric obstruction, closure, Collis wedge gastroplasty, comorbidities, COPD, coronary artery stents, cough, CT, delayed gastric emptying, diabetes, diaphragm, difficult cases, divided, division, Dumping syndrome, dysphagia, elderly, Endo GIA 45, esophageal length, Falsiform ligament, follow up, formal repair, fundus, G-tube, gastric volvulus, gastropexy, gastrostomy, GEJ, heartburn, hernia content, hernia sac, hiatus, HTN, hypotensive LES, intra-abdominal esophageal length, intra-abdominal esophagus length, Laparoscopic Management of Hiatal Hernias, large hernia, left crus, lesser curve, longitudonal fashion, manometry, mediastinum, medically frail patients, MI, midline incision, mobilization of the esophagus, nearly completely obstructed, Nissan Fundoplication, open paraesophageal hernia, partial fundoplication, PEH repair, PO intake, poor esophageal motility, post prandial chest pain, post-op, posteriorly, pulmonary fibrosis, recreation, recurrent pneumonias, reduce sac, regurgitation, relaxing incisions, resected, resection of the sac, right crurae, short esophagus, short vessels, side effects, SOB, stomach, straight esophagus, sutures, syptomatic, tolerate, tracing, Type III hiatal hernia, type IV hiatal hernia, unclosable hiatus, upper GI, vagus nerve, workup