Abstract
A key principle of hiatal hernia repair is mitigation of tension. While considerable emphasis is placed on the radial tension of the crural closure itself, of equal importance is assuring that axial tension on the esophagus is appropriately addressed. Because of this, esophageal lengthening procedures such as the transabdominal laparoscopic wedge Collis gastroplasty described here have been proposed. Such esophageal lengthening procedures allow for the creation of additional length of tubularized stomach to create a neo-esophagus that will allow for a tension free and appropriately sized fundoplication to be performed.
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