Laparoscopic Hiatal Hernia Repair With Mesh Cruroplasty

Zagazig University20 enrolled

Overview

The study you're referring to explores a surgical strategy for patients undergoing Laparoscopic Sleeve Gastrectomy (LSG) who also have a Hiatal Hernia (HH). Because obesity is a major risk factor for hiatal hernias, surgeons often find these defects during bariatric procedures

Study Type

INTERVENTIONAL

Allocation

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Hiatal Hernia Sleeve Gastrectomy

Interventions

Hiatal Hernia (HH) repair using mesh cruroplasty during a Laparoscopic Sleeve Gastrectomy (LSG)PROCEDURE

The procedure was performed laparoscopically under general anesthesia with the patient in a 30° reverse Trendelenburg position. Following pneumoperitoneum and five-trocar insertion, any adhesions from the previous Sleeve Gastrectomy (LSG) were released to expose the hiatus. Dissection: The gastrohepatic ligament was divided, and the hernia sac and gastroesophageal fat pad were fully reduced into the abdomen while preserving the hepatic branch of the vagus nerve. Repair: The crural defect was closed using 2-3 interrupted non-absorbable sutures to achieve a tension-free repair. Mesh Augmentation: A shaped polypropylene mesh was placed in an "onlay" fashion over the posterior crural repair, secured with endoscopic metal fixators, and covered with the remaining hernia sac flaps to protect the esophagus. Closure: After confirming hemostasis, trocars were removed and ports closed. Postoperative Management: Patients followed a standardized protocol involving gradua

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Adults (≥18 years), Patients underwent laparoscopic sleeve gastrectomy, Intraoperative confirmation of hiatal hernia, no prior history of esophageal or gastric surgery and Patient fit for general anesthesia Exclusion Criteria: * Patients with severe esophageal motility disorders, Patients with contraindications to laparoscopic surgery, Previous hiatal hernia repair, Esophageal stricture and perforation, Pregnancy or uncontrolled comorbidities, Presence of large paraesophageal hernias (\>4 cm) with volvulus, Contraindications to laparoscopic surgery, such as severe cardiopulmonary disease and Contraindication for general anesthesia.

Locations (1)

Zagazig Univeesity Hospitals

Zagazig, Egypt

Outcomes

Primary Outcomes

Evaluation of Hiatal Hernia (HH) Recurrence Rate

The primary objective is to determine the incidence of hiatal hernia recurrence following Laparoscopic Sleeve Gastrectomy (LSG) with concurrent mesh cruroplasty

Time frame: 6 months after the surgical procedure.

Data from ClinicalTrials.gov

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