We use cookies to offer you an optimal experience on our website. By browsing our website, you accept the use of cookies.

You must be logged in to watch this video. Click here to access your account, or here to register for free!

Management of a hiatal hernia during laparoscopic Roux-en-Y gastric bypass: be ready to repair

S Perretta, MD, PhD J Marescaux, MD, FACS, Hon FRCS, Hon FJSES, Hon FASA, Hon APSA
Epublication WebSurg.com, Jan 2012;12(01). URL: http://websurg.com/doi/vd01en3474

Ask a question to the author

You must be logged in to ask a question to authors. Click here to access your account, or here to register for free!
  • 1776
  • 15
  • 2012-01-16
Share it
Here we show the case of a 44-year-old woman with a BMI of 40.5 and a history of gastroesophageal reflux disease. She was presented for a weight reductive surgery evaluation. Preoperative esophagogastroduodenoscopy, barium swallow and esophageal high resolution manometry were performed. They demonstrated a 3cm hiatal hernia as well as a hypotensive lower esophageal sphincter. The presence of a large hiatal hernia (greater than 5cm) is problematic and may prevent successful weight reductive surgery. Laparoscopic Roux-en-Y gastric bypass is an effective procedure to control symptoms and GERD complications in morbidly obese patients. For this reason, Roux-en-Y gastric bypass is a valid alternative to manage morbidly obese patients with symptomatic hiatal hernia and GERD. Bsed on the preoperative work-up, decision was made to perform a concomitant paraesophageal hernia repair and a laparoscopic Roux-en-Y gastric bypass.