Surgical laparoscopy, endoscopy & percutaneous techniques
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Surg Laparosc Endosc Percutan Tech · Oct 2013
Laparoscopic paraesophageal hernia repair: critical steps and adjunct techniques to minimize recurrence.
Laparoscopic repair of paraesophageal hernias (PEH) is associated with a high objective hernia recurrence rate. Tension is a key factor in the repair of any hernia, and tension is a cause for hernia recurrence. ⋯ Efforts to reduce the objective recurrence rate after laparoscopic PEH repair should focus on minimizing tension with the use of a Collis gastroplasty and crural relaxing incisions when necessary. Similar to hernias at other sites, the use of mesh likely is another adjunct step that will improve outcomes with PEH repair, but to avoid erosion synthetic mesh should be avoided.