Nathan S Rubalcava, MD
Nathan S Rubalcava, MD; Gabriella A Norwitz; James D Geiger, MD; University of Michigan
Introduction: Repair of large hiatal hernias require adequate intra-abdominal esophageal length for best long-term outcomes and less rate of recurrence. When unable to attain this length without tension, the Collis gastroplasty is an invaluable technique.
Materials and Methods: After placement of the standard 5 laparoscopic trocars for hiatal hernia repair, use of an intra-thoracically placed 45-mm stapler allows for ideal articulation though the hiatus for ligation of the fundus and creation of the neo-esophagus. Bougie placement prior is critical to protect diameter of the esophagus
Results and Conclusion: We describe the use of a laparoscopic Collis gastroplasty with Nissen fundoplication in a 14-month-old who was diagnosed with a large right-sided hiatal hernia with the gastroesophageal junction in the subcarinal position.This is an ideal technique when the gastroesophageal junction cannot be brought below the diaphragmatic hiatus without tension.