III型裂孔疝腹腔镜修补

A giant type-III hiatal hernia containing all the stomach and the omentum. The body of the pancreas and the splenic artery are retracted at the base of the crura.The hernia sac is progressively detached with caution from the pleura, the pulmonary veins, the pericardium, the esophagus and the aorta. The esophagus is mobilized up to the carina in order to have enough intraabdominal length. The hernia sac is removed. The hiatus is closed with non absorbable sutures and the crura are reinforced with PTFE pledgets. A posterior fundoplication is fashioned and a piece of absorbable mesh is placed around the esophagus covering the cruroplasty .The operation total time was 105 minutes.

                               
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