Study of Laparoscopic Hiatus Hernia Repair at AVBRH

Hiatus hernia is a condition involving herniation of the contents of the abdominal cavity, most commonly the stomach, through the diaphragm into the mediastinum. In the United States, hiatus hernia was listed as a primary or secondary cause of hospital admissions in 142 of 10 000 inpatients between 2003 and 2006. because of high mortalty associated with this condition, elective repair is advised wherever paraesophageal hernia is found 25 cases having hiatus hernia with GORD were included in the study. All cases were operated in AVBR Hospital with Laparoscopic fundoplication. - Nissen procedure was performed - Manometry was not available, hence could be done in only 3 patients as they were willling to go to Asian institute. (hyderabad) - 24 hr ph monitoring couldnt be done as its a rural set up. - Hospital stay, mean hospital stay for patient was 5-6 days. Immediate post operatively complications were seen in 3 patients in which 2 presented with pneumothorax which were managed by ICD insertion for 3 days and 1 presented with severe belching which was managed conservatively. Laparoscopic repair has allowed shorter hospitalization (3-4 days) and recovery with short and long term results comparable to open repair with either an abdominal or thoracic approach. Elective laparoscopic surgical reduction and repair has an excellent success rate with low morbidity and mortality. Being a rural set up most of the patients we received were in advanced disease and few cases had herniation of entire stomach into thorax. Laparoscopic management of hiatus hernia is standard technique for management, even in advance cases.