Laparoscopic procedures for recurrent hiatal hernias

OBJECTIVE: To evaluate the immediate and long-term results of laparoscopic surgical procedures in patients with recurrent hiatal hernias (rHH). MATERIAL AND METHODS: Thirty-six patients with rHH underwent laparoscopic 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. Intraoperative revision established cuff and part of the stomach displacement into mediastinum as a cause of rHH in 31 cases, eruption of sutures on diaphragmatic crura - in 22 cases, no primary correction of short esophagus - in 9 cases. In 5 cases, we diagnosed distal displacement of cuff. There were no intraoperative or postoperative complications. Recurrence of HH within 5 (1-10) years was noted in 2 (5.5%) patients. CONCLUSION: Diaphragmatic crus repair with their reinforcement by mesh endoprostheses and Collis-Nissen esophagogastroplasty for short esophagus significantly reduce the risk of hiatal hernia recurrence.