Falciform Ligament Plug in Laparoscopic Hiatus Hernia Repair

Abstract

Background: A prospective and retrospective collected databases to identify outcome in Laparoscopic paraesophageal hiatal hernia repair is a challenging procedure. The falciform ligament is used as an autologous onlay flap to achieve tension-free closure of the crural defect of a para-esophageal hernia (PEH). Aim of the work: To assess the use of Falciform ligament for hiatus hernia repair and to evaluate the outcomes results. Patients and Methods: From December 2015 to august 2018, a total of 24 patients with para-esophageal hiatus hernia were conducted; Hernias were diagnosed with esophago-gastroscopy, barium contrast X-ray study and esophageal manometry. Results: twelve patients underwent falciform ligament plug repair while twelve patients underwent crural approximation and fundoplication repairs. The classical traditional procedure time for repairs was significantly longer (p=0.004). Hospital stays, resting lower esophageal sphincter pressure, and mean contraction amplitudes were similar between groups. Discussion: The well documented advantages of laparoscopic hiatal hernia repair less pain; shorter hospital stays, and faster recovery and the rates of failure are higher in patients had open repairs. Conclusion: Use of falciform ligament as a vascularized autologous onlay flap is a safe and effective procedure to close the crural defect of para-esophageal hiatus hernia.