PS01.068: LAPAROSCOPIC MANAGEMENT OF LARGE HIATAL HERNIA WITH SIMPLY SUTURE CLOSURE

Abstract

Abstract Background Laparoscopic approach has been demonstrated as safe and effective surgical access in approaching gastroesophageal reflux disease (GERD) and hiatal hernia repair. Several studies have proposed for repairing that hiatal hernia, especially large hiatus with mesh reinforcement. The objective of our study was to evaluate the effect of simple suture closure in management of large hiatus hernia (> 5 cm). Methods Between September 2012 to February 2018, 32 patients who underwent laparoscopic large hiatal hernia (> 5 cms hernia defect) repair by simply suture closure were included in our study. Different anti-reflux surgery was performed according to esophageal function examination. Peri-operative data and complications were retrospectively reviewed. 30-months complications and symptom control at 1 year were assessed by GERD-HRQL score and PPI use. Results 29 cases were performed completely with laparoscopy, with 3 cases with da Vinci Surgical System and 1 case through left thoracotomy. Hiatal hernia of all patients was repaired by simply suture closure, 24 cases were successfully operated with Nissen, 5 cases with, 2 cases with Dor and 1 case with Belsey Mark IV Fundoplication. At 3 months postoperatively follow-up, 94% of patients were off anti-reflux medications, abdominal pain occurred in 8.8(3 cases) of patients, mild dysphagia occurred in 1 patient, and 2 patients with severe dysphagia required dilator therapy. Two patients (5.9%) developed recurrence on routine follow up. Conclusion Our study showed simply suture closure was a feasible technique for repair large hiatus hernia. The advantages between laparoscopic mesh cruroplasty and simply suture closure for large hiatal hernia repair, randomised controlled trials are needed. Disclosure All authors have declared no conflicts of interest.