Abstract
Introduction: The laparoscopic surgical treatment of hiatal hernia has lead to an improvement of the surgical results and nowadays it is accepted as the standard approach. Through the years the technique has evolved and several modifications were introduced. Aim: We present a retrospective study of 260 consecutive patients, operated on from 2001 to 2015 at the Department of General and Operative surgery, UMHAT `St. Marina` - Varna, Bulgaria.Results: Hiatal hernia types included axial hernia (n=67, 26%), paraesophageal hernia (n=13, 5%), mixed type (n=104, 40%), giant hiatal hernia (n=76, 29%). Overall, 215 (82.7%) patients had Nissen fundoplication and 45 (17.3%) had partial fundoplication. All patients underwent a posterior repair of the crura and 38 (14.6%) - additional anterior suture. Esophageal shortening of different severity was identified in 79 (30.4%) patients. Excellent results were achieved in 95%. The shortened esophagus is considered an important factor for hiatal hernia recurrence. Conclusion: The laparoscopic hiatal hernia repair has been proven as a feasible technique with excellent results, minimal morbidity and mortality with growing popularity amongst the patients. Esophageal lengthening procedures should be considered in selected groups of patients.
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