title: [Heterotaxy-polysplenia, approach to the esophageal hiatus for Nissen technique].
abstract: BACKGROUND
  Heterotaxy is a failure in embryonic development to achieve left-right symmetry.
  
  
  OBJECTIVE
  To report a case of heterotaxy and show a surgical approach for fundoplication.
  
  
  METHODS
  A girl with heterotaxy-polysplenia syndrome with gastroesophageal reflux and recurrent abdominal pain. It was decided to perform laparoscopic antireflux treatment with Nissen fundoplication with approach by the right side of the diaphragmatic hiatus and pillars.
  
  
  CONCLUSIONS
  Surgery is being discussed in these syndromes, indicating only in cases of recurrent abdominal pain, subocclusive lesions or when diagnosis of gastroesophageal reflux is done. The dilemma is between laparoscopic or classical laparotomy. The main difficulty of the laparoscopic approach is the enlarged liver and stomach placement right despite the esophageal hiatus is normally on the left side.
authors.affiliation: Hospital Universitario 12 De Octubre, Madrid. malopezd.hdoc@salud.madrid.org
authors.forename: M
authors.initials: M
authors.lastname: López Díaz
authors.forename: I
authors.initials: I
authors.lastname: Cano Novillo
authors.forename: R
authors.initials: R
authors.lastname: Tejedor Sánchez
authors.forename: S
authors.initials: S
authors.lastname: Fuentes Carretero
authors.forename: A
authors.initials: A
authors.lastname: Gómez Fraile
mesh_terms: D002675:Child, Preschool; D005260:Female; D018662:Fundoplication / Q000379:methods*; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000601:surgery*; D059446:Heterotaxy Syndrome / Q000150:complications*; D006801:Humans