Hiatal hernia surgery corrects the hernia by pulling the stomach back into the abdomen and making the opening in the diaphragm smaller, while the fundoplication tightens the lower esophageal sphincter. Reflux esophagitis, sliding hiatal hernia and the anatomy of repair. Unable to load your collection due to an error, Unable to load your delegates due to an error. The posterior aspect of fundus must be sufficiently dissected out so it can be used later for suturing without tension. The attachment of the left lobe of the liver is released by dividing the anterior and posterior leaves of the triangular ligament parallel to the liver edge. The surgical management of adult patients with GERD is reviewed in this topic. He said he doesn't do the Nissen any more because too many people have problems with it. The Hill repair is based on re-establishing normal anatomy by restoration of the gastroesophageal flap valve. Aug 8, 2017. Leaving the NG tube in place, the dilator is removed and a manometric reading is taken. The preaortic fascia is lifted up off the aorta with a Babcock clamp. The results of Hill's operation - OESO Achalasia, biliary disease, esophageal spasm, peptic ulcer disease, and cardiac ailments are some of the disorders that can clinically mimic gastroesophageal reflux disease. The type ofoperation should not be based on preference, but on what the patient NEEDS. hill procedure vs nissen - kestonrocks.com The repair is modified according to the reading of the manometer and anatomic appearance. 1997 Nov;98(11):947-52. MeSH Ann Thorac Surg 2012; 94:951. In some obese patients these bundles are extremely redundant and we do not hesitate to resect part of them. Technique d'oesophago-gastroplastie avee phr$eAnogastropexie apliqu$eAe dans la cure radicale des hernies hiatales et comme compl$eAment de l'operation d'Heller dans les cardiospasmes. Laparoscopic approach has been reserved to primary cases. The laparoscopic Nissen, and laparoscopic Hill procedures have been proven to have excellent results for the treatment of GERD. We do not routinely use a bougie in open cases.