Anne Arundel Medical Center, 2001 Medical Parkway, Annapolis, MD 21401, USA.
J Gastrointest Surg. 2012 Jul;16(7):1417-21. doi: 10.1007/s11605-012-1888-4. Epub 2012 May 1.
Laparoscopic repair of a giant paraesophageal hiatal hernia remains a challenging procedure. Several techniques have been developed in efforts to achieve tension-free reconstruction of the esophageal hiatus. In this report, we describe a technique whereby the falciform ligament is used as an autologous onlay flap to achieve tension-free closure of the crural defect of a giant paraesophageal hernia (GPEH).
Use of the falciform ligament as a vascularized autologous onlay flap is a safe and effective procedure to obtain closure of the crural defect of a GPEH. The falciform ligament should be adequately mobilized from the anterior abdominal wall to prevent lateral tension on the flap, but care must be taken to avoid devascularization. Interrupted vertical mattress sutures are used to fix the falciform ligament to the left and right hiatal crurae.
腹腔镜修复巨大食管裂孔疝仍然是一项具有挑战性的手术。为了实现食管裂孔无张力重建，已经开发了多种技术。在本报告中，我们描述了一种使用镰状韧带作为自体嵌片瓣的技术，以实现巨大食管裂孔疝（GPEH）裂孔旁缺损的无张力关闭。
使用镰状韧带作为带血管的自体嵌片瓣是一种安全有效的方法，可获得 GPEH 裂孔旁缺损的关闭。应从前腹壁充分游离镰状韧带，以防止瓣的侧向张力，但必须注意避免血运障碍。间断垂直褥式缝线用于将镰状韧带固定到左右食管裂孔旁。
