PMC6441758_01
Barium swallow study pre-operatively showing the hiatal hernia (A) and post-operatively showing no evidence of leak with proper position of the stomach (B).
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The barium study confirmed the presence of hiatal hernia (Fig. 1A). In the first post-operative day, the patient had Gastrografin swallow and meal which demonstrated no evidence of leak with proper position of the stomach (Fig. 1B).
Laparoscopic view of the hiatal hernia in which the gastric fundus had invaginated into the hernia sac (A) and hernia defect after completing the repair (B).
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A giant hiatal hernia was noted with the gastric fundus herniated into the thoracic cavity (Fig. 2A). A 360-degree Nissen fundoplication was carried out forming a wrap that measures about 2 cm in length (Fig. 2B).
Laparoscopic view of the Morgagni hernia in which the falciform ligament had invaginated into the hernia sac (A) and hernia defect after the repair (B).
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Furthermore, a small-sized left-sided Morgagni hernia containing a falciform ligament was seen incidentally (Fig. 3A). It was closed using continuous suturing of STRATAFIX  3.0 (Knotless Tissue Control Device - Ethicon, NJ, USA) and no mesh was used (Fig. 3B).