Experience with laparoscopic treatment for paraesophageal hiatal hernia

Paraesophageal hiatal hernia is often associated with a number of complications such as intestinal obstruction, gastric volvulus and acute pancreatitis, each of which can result in critical conditions requiring surgery. Herein, we report our surgical procedure for paraesophageal hiatal hernia.Since 2003, we have surgically treated hiatal hernia in 18 patients, including 2 men and 16 women, with a mean age of 73 years. Thirteen patients (72.2%) had a type-I hiatal hernia, two (11.1%) had type III and three (16.7%) had type IV. The operative procedure consisted of a crural repair and anti-reflux maneuver.Laparoscopic procedures were completed in all patients. The mean operation time was 160.2 min for type I and 230.8 min for types III and IV. The mean postoperative hospital stay was 7.8 days, and there was no mortality. Three patients relapsed during the mean follow-up period of 74.9 months. Two of them were asymptomatic and one required laparoscopic reoperation.Laparoscopic surgery for paraesophageal hiatal hernia is safe and effective with minimal morbidity and early recovery. However, it is important to determine the appropriate timing of surgery based on the severity of the hernia and the patient's general status and comorbidities.