PMC9481408_01
Computed tomography of the thorax, abdomen, and pelvis. Coronal reconstruction showing a giant HH involving the stomach and part of the duodenum and transverse colon. The blue arrow corresponds to the esophagus compressed by the hiatal hernia; the red arrow corresponds to the duodenum.
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fig1
HH containing a volvulated stomach with edema of its walls without necrosis; in addition, the first two portions of the duodenum and the transverse colon, occupying the right thoracic cavity (Figure 1). High-resolution manometry was not conducted due to the need for emergency surgery.
Diagram indicating the position of the trocars. The left and right 10 mm ports are for the surgeon's hands. The supraumbilical port is for the camera. The liver retractor uses the 5 mm subxiphoid incision. Assistant's left hand uses the 5 mm port located on the left flank. Supplementary material (video): https://youtu.be/OMXmnDmL6uU.
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fig2
Laparoscopic hiatal hernioplasty was performed with gastropexy of the gastric fundus (Figure 2 shows the position of the trocars; Figures 3 and 4 and video show the surgical technique).
Video screenshot: anterior dissection.
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fig3
Laparoscopic hiatal hernioplasty was performed with gastropexy of the gastric fundus (Figure 2 shows the position of the trocars; Figures 3 and 4 and video show the surgical technique).
Video screenshot: closure of hiatus.
CRIS2022-1855656.004.jpg
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fig4
Laparoscopic hiatal hernioplasty was performed with gastropexy of the gastric fundus (Figure 2 shows the position of the trocars; Figures 3 and 4 and video show the surgical technique).