Minimally invasive surgery is the mainstay of treatment for symptomatic hiatal hernia. Laparoscopic paraesophageal hernia (PEH) repair includes certain key steps such as complete reduction of the hernia sac, identification of both crura and the gastroesophageal junction, obtaining at least 3cm of intra-abdominal esophageal length, tension-free re-approximation of the crura utilizing an absorbable mesh onlay, creation of an anti-reflux procedure, and diagnostic endoscopy at the end of the procedure. This article reviews various aspects of managing a patient who presents with a paraesophageal hernia and examines the current controversies in surgical technique with regards to laparoscopic PEH repair.
- Nissen fundoplication
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