Minimally invasive surgical techniques have revolutionized the treatment par esophageal hernia—but there's continued controversy over some key technical aspects of the procedure. Five nationally recognized leaders in fore gut surgery "systematically and point-by-point" outline their approach to this effective but technically challenging procedure. The special feature section provides "a fascinating picture in which all authors agree that the basic principles of the operation should be respected," according to an introductory article by Dr. Sanjay Kolte. "
Paraesophgeal hernia is a common condition in which part of the stomach becomes herniated through the diaphragm and into the chest—higher than the junction between the esophagus and stomach. In addition to stomachache and difficulty swallowing, patients may experience chest pain, especially after meals, and shortness of breath. When other treatments can't relieve symptoms, surgery is recommended.
In the past, surgery was performed through an open incision in the abdomen or chest. But over the past decade, minimally invasive laparoscopic approaches have revolutionized the treatment of Paraesophgeal hernia.
Laparoscopic surgery provides excellent results with a low rate of recurrent hernia, less pain, and faster recovery.
But the laparoscopic procedure is technically challenging, with a "long learning curve" for surgeons, and is best performed by experienced specialists at referral medical centers. And even among the experts, there is ongoing debate regarding key areas of surgical technique.
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