Combined treatment of symptomatic massive paraesophageal hernia in the morbidly obese.

Journal Article (Journal Article)

INTRODUCTION: Repair of large paraesophageal hernias by itself is associated with high failure rates in the morbidly obese. A surgical approach addressing both giant paraesophageal hernia and morbid obesity has, to our knowledge, not been explored in the surgical literature. METHODS: A retrospective review of a bariatric surgery database identified patients who underwent simultaneous repair of large type 3 paraesophageal hernias with primary crus closure and Roux-en-Y gastric bypass (RYGB). Operative time, intraoperative and 30-day morbidity, weight loss, resolution of comorbid conditions and use of antireflux medication were outcome measures. Integrity of crural closure was studied with a barium swallow. RESULTS: Three patients with a mean body mass index of 46kg/m(2) and mean age of 46 years underwent repair of a large paraesophageal hernia, primary crus closure, and RYGB. Mean operative time was 241 minutes and length of stay was 4 days. There was no intraoperative or 30-day morbidity. One patient required endoscopic balloon dilatation of the gastrojejunostomy. At 12 months, all patients were asymptomatic with excellent weight loss and resolution of comorbidities. Contrast studies showed no recurrence of the hiatal hernia. CONCLUSION: Simultaneous laparoscopic repair of large paraesophageal hernias in the morbidly obese is safe and effective.

Full Text

Duke Authors

Cited Authors

  • Kasotakis, G; Mittal, SK; Sudan, R

Published Date

  • April 2011

Published In

Volume / Issue

  • 15 / 2

Start / End Page

  • 188 - 192

PubMed ID

  • 21902973

Pubmed Central ID

  • PMC3148869

International Standard Serial Number (ISSN)

  • 1086-8089

Digital Object Identifier (DOI)

  • 10.4293/108680811X13022985132164


  • eng

Conference Location

  • United States