Surgery of the Hiatus
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Laparoscopic and Open Nissen Fundoplication
- Evidence of gastroesophageal reflux disease (GERD) plus:
- Sequelae of GERD refractory to medical therapy (eg, esophageal strictures, Barrett’s esophagus, recurrent aspiration, or pneumonia).
- Persistent reflux symptoms despite maximal medical therapy.
- Paraesophageal hernia.
Laparoscopic and Open Paraesophageal Hernia Repair
- Objective evidence of paraesophageal herniation.
- Many patients are asymptomatic and a large number of cases are found incidentally.
- Inability to tolerate general anesthesia.
- Uncorrectable coagulopathy.
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