Request PDF on ResearchGate | On Jan 1, , D. Collet and others published Hernies hiatales et autres pathologies diaphragmatiques. Le traitement chirurgical vidéolaparoscopique des hernies hiatales par roulement est réalisable sans difficultés techniques majeures. Il est possible même chez. Although congenital and posttraumatic diaphragmatic hernias were described as far back as the 16th century, hiatal hernia was not recognized as a significant.

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Traitement laparoscopiquedes volumineuses hernies hiatales – EM|consulte

He used 4 or hernids interrupted sutures, 1 or more of which also incorporated part of the anterior wall of the esophagus. The physiologic link between HH and gastroesophageal reflux was made at the second half of the 20 th century by Allison and Barrett. Additionally, he proposed a grading system of the flap valve mechanism that correlated with the patient’s reflux status better than the measurement of the lower esophageal sphincter pressure alone.

Access hernis the text HTML. The gastroesophageal flap valve. By using this site, you agree to the Terms of Use and Privacy Policy. In hiataless, the gastric fundus upper part of the stomach is wrapped, or plicated, around the inferior part of the esophagus, preventing herniation of the stomach through the hiatus in the diaphragm and the hiataels of gastric acid.

Please review our privacy policy. Is mesh used in hiatal hernia surgery? The Mayo clinic group refined the criteria for patient selection, choosing to observe patients whose hiatal hernias were discovered radiographically during the course of hernise general examination.

Reduction of the cardia below the diaphragm was felt to be a key to maintaining the cardiophrenic angle and hence competence of the lower esophageal sphincter. The widespread availability of physiologic testing with esophageal motility studies and hour pH probe studies has greatly improved the identification of those patients likely to benefit from surgery.

He was courageous hrenies to report this to the American Surgical Association meeting in Additionally, he considered long-term follow-up to be the only means for the assessment of a new surgical technique.

If the condition has been brought on by stress, stress reduction techniques may be prescribed, or if overweight, weight loss may be indicated.


The motility and pharmacology of the oesophagus in cardiospasm. Taste of acid in the back of the mouth, heartburntrouble swallowing [1].

They occur when a portion of the stomach pushes up into the chest adjacent to the esophagus. Wideochir Inne Tech Maloinwazyjne. The cause of a hiatal hernia is unknown, but possible triggers include coughing, vomiting, straining while having a bowel movement, sudden physical exertion and pregnancy. The technique, however, was not without significant merit. Symptoms from a hiatal hernia may be improved by changes such as raising the head of the bed, weight loss, and adjusting eating habits.

Medication may herniew prescribed to neutralize stomach acid, decrease acid production or strengthen the lower esophageal sphincter a muscle that prevents stomach acid from coming up into the esophagus.

Massive hiatal hernias: the anatomic basis of repair.

JCHIR Traitement laparoscopiquedes volumineuses hernies hiatales. The clinical outcome was excellent and was reproduced in a subsequent patient. They are most often true nontraumatic hernias and can be classified in 3 groups: Allison should be credited for initiating the modern era of antireflux surgery. He further elucidated the mechanism of gastroesophageal reflux using manometry to demonstrate the existence of a high-pressure zone in the terminal esophagus.

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Donahue and Demeester significantly improved Nissen’s operation, and they were the first to truly understand its physiologic mechanism. More severe symptoms are usually associated with a paraesophageal hernia. He called his final procedure Mark IV to serve notice that this was not his first thought and possibly not his last on the subject but the result of a series of surgical trials designated as Marks I, II and III. Exstirpation eines ganzen Lungenflugels.

The senior author’s experience and personal communications are also reported. A chest X-ray showing a large hiatal hernia with air-fluid level, which suggests that fluid is being retained in the stomach. The original operation underwent modifications by Nissen himself, as well as by other surgeons. The vast majority of paraesophageal hernias continue to be repaired in a minimally invasive manner at Mass General. Hill then designed an operation that restored the angle of His by reapproximating the phrenoesophageal bundles and anchoring them to the median arcuate ligament.

InHenry Ingersoll Bowditch 5 reviewed all cases of diaphragmatic hernia published between and If you are a subscriber, please sign in ‘My Account’ at the top right of the screen.


The wrap was performed around a large-bore indwelling intraesophageal stent. While Nissen was performing his initial fundoplications, Lucius Hill carefully studied the physiology and anatomy of the gastroesophageal junction and esophageal hiatus Fig.

There were also 7 postoperative deaths. Closure of the hiatus was recognized as an essential part of all antireflux procedures to avoid herniation of the fundoplication. This hiatal hernia is mainly identified by an air-fluid level labeled with arrows. He was the herniee Western surgeon to perform a successful pneumonectomy, reporting this in2 years before Evarts Graham did so in the Hiatalees States.

He believed these crural fibers functioned as a pinchcock to prevent reflux.

InAke Akerlund 21 in Stockholm reported 30 more cases, proposed the term hiatus herniaand classified hiatal hernias into 3 types. In the great majority of cases, sufferers experience no life-altering discomfort, and no treatment is required. The patient recovered completely and remained free of symptoms throughout a follow-up of more than 15 years.

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Fixation of the lesser curve of the stomach to the anterior abdominal wall after reposition of the hernia through the esophageal hiatus. This lack of interest is not easily explained, because diaphragmatic hernias give rise to so many complicated and serious symptoms, which if not properly attended to, will lead the patient to an unfortunate life and premature death.

Hiatal Hernia in the First Half of the 20 th Century The advent of radiography was the first important step in the diagnosis and management of hiatal hernia.

Henry Ingersoll Bowditch reviewed the early series of hiatal hernias described at postmortem examination in and probably should be credited with the first description of what is now referred to as a paraesophageal hernia. Intraluminal pressure, transmucosal potential difference and pH studies in the oesophagus of patients before and after Collis repair of a hiatal hernia.

Carl Rokitansky, 7 a pathologist in Vienna indemonstrated that esophagitis of the lower esophagus was due to gastroesophageal reflux. Technique for Radical Cure.

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