Hammar Alyssa M, Zelle Leanna, Nischwitz Erin, Wheeler Andrew A, Thaqi Milot
Department of General Surgery, University of Missouri School of Medicine, Columbia, USA.
Cureus. 2024 Jul 17;16(7):e64757. doi: 10.7759/cureus.64757. eCollection 2024 Jul.
We present a female in her sixties with a recurrent paraesophageal hernia status post open Nissen fundoplication and multiple esophageal dilations who underwent a robotic paraesophageal hernia repair, with extensive lysis of adhesions. The stomach and esophagus were dissected off the crura and the previous wrap was undone. Once the entirety of the stomach and esophagus were freed from their surrounding structures, the hernia sac was able to be excised. The crural defect was closed and gastropexy was performed. The patient had an uneventful postoperative course and was discharged home. This case is presented to provide evidence that robotic repair presents a viable option in the reoperation of patients following an open Nissen fundoplication as well as provide an overview of the types of hiatal hernias and the indications and options for surgical intervention.
我们介绍了一位60多岁的女性，她患有复发性食管旁疝，曾接受过开放性nissen胃底折叠术和多次食管扩张，此次接受了机器人辅助食管旁疝修补术，并进行了广泛的粘连松解。将胃和食管从脚部分离，解开先前的包裹。一旦胃和食管完全从周围结构中游离出来，就可以切除疝囊。缝合脚的缺损并进行胃固定术。患者术后恢复顺利，已出院回家。本病例旨在证明机器人修复术是开放性nissen胃底折叠术后患者再次手术的可行选择，并概述食管裂孔疝的类型以及手术干预的适应症和选择。
