Objective. To evaluate the immediate and long-term results of laparoscopic procedures in patients with recurrent hiatal hernias (rHH). Material and methods. Thirty-six patients with rHH underwent laparoscopic surgery with mesh repair and Nissen fundoplication between 2015 and 2024. Nine patients underwent Collis—Nissen esophagogastroplasty due to intraoperative confirmation of short esophagus. Results. Mean surgery time was 3 (2—4.5) hours, length of hospital-stay — 7 (5—15) days. According to intraoperative data, rHH was caused by misplaced fundoplication cuff and part of the stomach into mediastinum in 31 cases. In 22 cases, the cause of displacement was eruption of sutures on diaphragmatic crura, in 9 cases — uncorrected short esophagus after primary surgery. Distal displacement of fundoplication cuff was diagnosed in 5 cases. There were no intraoperative or postoperative complications. Recurrence of HH throughout 5 (1—10) years was noted in 2 (5.5%) patients. Conclusion. Diaphragmatic crus repair with mesh reinforcement for normal esophageal length and Collis—Nissen esophagogastroplasty for short esophagus can significantly reduce the risk of recurrent hiatal hernia.
Starkov et al. (Fri,) studied this question.