title: How I do it: laparoscopic paraesophageal hernia repair.
abstract: BACKGROUND
  Paraesophageal hernias are usually complex anatomic abnormalities of the upper gastrointestinal tract capable of causing symptoms and complications including death. Furthermore, they affect patients who are usually older and have other comorbidities. Preferred treatment approach has evolved over time, with laparoscopic repair being the current preferred technique as it causes less hemodynamic changes and is better tolerated than open repairs.
  
  
  METHODS
  In this report, we describe our technique for laparoscopic paraesophageal hernia repair. The most salient technical aspects of this procedure include reduction of the stomach below the diaphragm, circumferential dissection and excision of the hernia sac, closure of the crural defect with our without the addition of mesh, and fundoplication to prevent reflux.
  
  
  CONCLUSIONS
  While this procedure has a low morbidity risk and short hospital stay, anatomic recurrence is frequent even when performed by experienced surgeons.
authors.affiliation: Department of Surgery, University of Washington, 1959 NE Pacific Street, Box 356410, Seattle, WA 98195, USA.
authors.forename: Edward D
authors.initials: ED
authors.lastname: Auyang
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Pellegrini
mesh_terms: D018662:Fundoplication; D006551:Hernia, Hiatal / Q000601:surgery*; D059685:Herniorrhaphy / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D013526:Surgical Mesh