18854 Cloonan.mp4 (1.48 GB)

Robotic-Assisted Paraesophageal Hernia Repair: Operative Anatomy and Technical Considerations

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posted on 2023-04-10, 15:09 authored by Daniel J Cloonan, Cameron T Stock, Elliot L Servais, Ammara A Watkins

Paraesophageal hernia repair with fundoplication is a case that utilizes the strengths of robotic-assisted surgery well. This video reviews the technical details of robotic-assisted paraesophageal hernia repair, with a focus on operative anatomy and key steps to help give early learners a framework for understanding this operation. Starting with patient positioning, patient and robot setup are demonstrated. Then, the presentation moves to hernia reduction and crural dissection, highlighting important anatomical structures that serve as operative landmarks and key components of the repair. Crural repair is then demonstrated with two techniques for approaching fundoplication. The video closes on postoperative management of patients after paraesophageal hernia repair.

This video is meant to help early career learners develop an understanding of the case while also providing more experienced learners with tips and tricks for a successful operation.

Reference(s)

1. Nason KS, Luketich JD, Witteman BP, Levy RM. The laparoscopic approach to paraesophageal hernia repair. J Gastrointest Surg. 2012;16(2):417-426. doi:10.1007/s11605-011-1690-8

2. Karush, J, Sarkaria IS. Robotic-assisted giant paraesophageal hernia repair and Nissen fundoplication. Operative Techniques in Thoracic and Cardiovascular Surgery 2013; 18(3)204-214. Doi: 10.1053/j.optechstcvs.2013.10.002