ArticleSurgical endoscopy2015
Assessment and reduction of diaphragmatic tension during hiatal hernia repair.
Article in Surgical endoscopy, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed, 60 citations in OpenAlex.
- Quantification of tension during cruroplasty of robotic-assisted hiatal hernia repairs using force feedback instruments on the da Vinci surgical platform (dV5).Surgical endoscopy · 2026Article
- Reflections on surgery for hiatal hernia.Updates in surgery · 2026Review
- Dynamics of hiatal hernia recurrence: how important is a composite crural repair?Hernia : the journal of hernias and abdominal wall surgery · 2024Review
- Does crural repair with biosynthetic mesh improve outcomes of revisional surgery for recurrent hiatal hernia?Hernia : the journal of hernias and abdominal wall surgery · 2024Observational
- BRAZILIAN HERNIA AND ABDOMINAL WALL SOCIETY STATEMENT ON LARGE HIATAL HERNIAS MANAGEMENT.Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery · 2024Article
- Impact of laparoscopic repair on type III/IV giant paraesophageal hernias: a single-center experience.Hernia : the journal of hernias and abdominal wall surgery · 2023Article
- LAPAROSCOPIC ANTIREFLUX SURGERY: ARE OLD QUESTIONS ANSWERED? MESH HERNIOPLASTY.Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery · 2023Article
- Evaluation of post-operative dysphagia following anti-reflux surgery.Surgical endoscopy · 2022Article
- Characteristics and outcomes of patients undergoing paraesophageal hernia repair with selective use of biologic mesh.Surgical endoscopy · 2022Article
- Practice-Changing Milestones in Anti-reflux and Hiatal Hernia Surgery: a Single Surgeon Perspective over 27 years and 1200 Operations.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2021Article
- The use of biosynthetic mesh in giant hiatal hernia repair: is there a rationale? A 3-year single-center experience-author's reply.Hernia : the journal of hernias and abdominal wall surgery · 2021Article
- Comment to: the use of biosynthetic mesh in giant hiatal hernia repair: is there a rationale? A 3-year single-center experience.Hernia : the journal of hernias and abdominal wall surgery · 2020Article
- Combination of Surgical Technique and Bioresorbable Mesh Reinforcement of the Crural Repair Leads to Low Early Hernia Recurrence Rates with Laparoscopic Paraesophageal Hernia Repair.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2020Article
- Use of computed tomography volumetric measurements to predict operative techniques in paraesophageal hernia repair.Surgical endoscopy · 2020Article
- Quantifying tension in tension-free hiatal hernia repair: a new intra-operative technique.Surgical endoscopy · 2019Article
- Minimally invasive surgery for large hiatal hernia.Annals of gastroenterological surgery · 2019Review
- Salvage Options for Fundoplication Failure.Current gastroenterology reports · 2019Review
- The Optimal Approach to Symptomatic Paraesophageal Hernia Repair: Important Technical Considerations.Current gastroenterology reports · 2016Review
- The use of crural relaxing incisions with biologic mesh reinforcement during laparoscopic repair of complex hiatal hernias.Surgical endoscopy · 2016Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDuring hiatal hernia repair there are two vectors of tension: axial and radial. An optimal repair minimizes the tension along these vectors. Radial tension is not easily recognized. There are no simple maneuvers like measuring length that facilitate assessment of radial tension. The aims of this project were to: (1) establish a simple intraoperative method to evaluate baseline tension of the diaphragmatic hiatal muscle closure; and, (2) assess if tension is reduced by relaxing maneuvers and if so, to what degree.
methodsDiaphragmatic characteristics and tension were assessed during hiatal hernia repair with a tension gage. We compared tension measured after hiatal dissection and after relaxing maneuvers were performed.
resultsSixty-four patients (29 M:35F) underwent laparoscopic hiatal hernia repair. Baseline hiatal width was 2.84 cm and tension 13.6 dag. There was a positive correlation between hiatal width and tension (r = 0.55) but the strength of association was low (r (2) = 0.31). Four different hiatal shapes (slit, teardrop, "D", and oval) were identified and appear to influence tension and the need for relaxing incision. Tension was reduced by 35.8 % after a left pleurotomy (12 patients); by 46.2 % after a right crural relaxing incision (15 patients); and by 56.1 % if both maneuvers were performed (6 patients).
conclusionsTension on the diaphragmatic hiatus can be measured with a novel device. There was a limited correlation with width of the hiatal opening. Relaxing maneuvers such as a left pleurotomy or a right crural relaxing incision reduced tension. Longer term follow-up will determine whether outcomes are improved by quantifying and reducing radial tension.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.