Review of Literatures on Laparoscopic Prosthetic Repair of Giant Hiatal Hernia than Pure Anatomical Repair of Crura

The esophagus passes through an opening in the diaphragm (i.e. esophageal hiatus) as it courses through the chest to the abdomen eventually ending at the stomach. This opening is usually adequate for passage of the esophagus and nothing else (Fig. 1). However, patients that have a hiatal hernia have an enlarged opening. There are four different types of hiatal hernias described. Giant hiatal hernia is defined as greater than one third of the stomach in the thoracic cavity1 and representing 5 to 10% of all hiatal hernia.2 The hiatal opening in a patient with a large hernia is wide, with the right and left Crura very thin and often separated by 5 cm or more.2 Types of hiatal hernia are represented diagrammatically in Figures 1 to 2D. Traditionally repair of giant paraesophageal hernia has been performed through laparotomy or thoracotomy, with the advent of laparoscopy, nowadays giant hiatal hernia (type III, type IV) are performed with laparoscopy.3 The recurrence rate after laparoscopic repair of hiatal hernias with paraesophageal involvement (LRHP) is reported to be high.4 Several recent reports have shown laparoscopic repair of paraesophageal hiatal hernia.5-7 Suggesting that it is feasible and effective obtaining comparative result to open surgery. Abstract