Introduction: The laparoscopic approach is particularly suitable for surgery of the esophageal hiatus. However, an increasing number of early recurrences requiring reintervention have been observed and it has been proposed that reinterventions of the hiatus may be feasible using the laparoscopic approach, which maintains the advantages of a minimally-invasive procedure. Objective: The aim of this study was to evaluate the immediate results of laparoscopic reoperative hiatal surgery. Material and methods: Between January 1998 and September 2000, 126 surgical interventions on the esophageal hiatus were performed (101 for reflux and/or hiatus hernia and 25 for achalasia). Seven patients had previously undergone surgery. Age, type of prior surgery, hospital stay, conversion and morbidity were analyzed. Results: This series included 3 men and 4 women. Of these, 5 had undergone open surgery (3 for hiatus hernia, 1 for achalasia and 1 for perforated duodenal ulcer). Two patients had undergone laparoscopic surgery for hiatus hernia. In 6 of the 7 patients underwent laparoscopic reoperation with a mean operating time of 230 minutes (180-300). Four Nissen fundoplications and 1 extension of the myotomy plus Dor fundoplication were performed. Mean hospital stay was 3.5 days. No complications were observed and the patients remain asymptomatic after a follow-up of 9.8 months (range: 4-17 months). Conclusions: Laparoscopic reoperation of the esophageal hiatus is feasible. The postoperative evolution is similar to the other laparoscopic reoperations.
|Publication status||Published - 1 Jan 2001|
- Hiatus hernia