A review of laparoscopic paraesophageal hernia repair

Background: Laparoscopic repair of paraesophageal hernias (PEH) is replacing the open approach. Regardless of the technique, certain aspects of the repair have proven to be beneficial while others remain controversial. Methods: Review of the literature. Results: Surgical correction of paraesophageal hernias (PEH) is the gold standard for symptomatic patients, the role of surgery in asymptomatic patients is less clear. There is not good evidence-based data to support the routine addition of an antireflux procedure. Prosthetic repair of large defects has been both advocated and condemned in the literature. Conflicting data make it unclear whether the potential benefits outweigh the risk of mesh-related complications. The incidence and clinical significance of PEH recurrence after laparoscopic repair remain undefined. The recurrence rate in the literature after laparoscopic PEH repair ranges from 0 to 42%. Conclusions: Laparoscopic paraesophageal hernia repair is a challenging procedure, but with meticulous technique, provides excellent results.