In Support of Standard Procedure in Hiatal Hernia Repair
ABSTRACT Laparoscopic esophageal surgery has gained popularity due to the unprecedented view it allows of esophageal hiatal hernias
and the ease of access to the surgical site offered by the minimal-access approach. Numerious series have demonstrated the
safety and efficacy of approaching gastroesophageal reflux disease (GFRD) and hiatal hernia repair laparoscopically [1, 2]. Despite increasing experience with laparoscopic hiatal hernia repair, authors continue to report recurrence rates of up
to 43% with sutured cruroplasty [3, 4]. This compares laparoscopic hiatal hernia repair poorly with open rapair, as it is well documented that open hiatal hernia
repair with the addition of Stamm gastrostomy is associated with very low recurrence rates [5, 6]. Additionally, intrathoracic wrap migration rates of up to 26% have been reported for patients undergoing laparoscopic fundoplication
with primary sutured hiatal hernia repair .