Laparoscopic Hiatal Hernia Repair

Laparoscopic hiatal hernia repair is a minimally invasive operation to correct a hiatal hernia, the protrusion of part of the stomach through the diaphragm, performed with a laparoscope through several small port incisions rather than one large opening. The surgeon separates the diaphragm's crura from the esophagus while preserving the vagus nerves, pulls the esophagus partly back into the abdomen so that at least three centimeters sits below the diaphragmatic opening, and then closes the enlarged opening with sutures. The repair is usually combined with a fundoplication that wraps part of the stomach around the esophagus, a full three hundred sixty degree Nissen wrap or a partial Toupet or Dor wrap, with the partial wraps preferred for patients who have trouble with esophageal motility since they allow easier swallowing afterward.