Evidence map›Paper›PMID 36261642›Full record

ArticleSurgical endoscopy2023

Type II hiatal hernias: do they exist or are they actually parahiatal hernias?

Rocio E Carrera Ceron, Robert B Yates, Andrew S Wright, H Alejandro Rodriguez, Rebecca G Lopez, Carlos A Pellegrini, Brant K Oelschlager

Abstract read
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In one paragraph

Article in Surgical endoscopy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Laparoscopic repair of parahiatal hernia: surgical techniques and literature reviews.Hernia : the journal of hernias and abdominal wall surgery · 2025
    Review
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Rocio E Carrera CeronDepartment of Surgery, University of Washington, 1959 NE Pacific St, Box 356410, Seattle, WA, 98195, USA.ORCID http://orcid.org/0000-0003-2551-3227
Robert B YatesDepartment of Surgery, University of Washington, 1959 NE Pacific St, Box 356410, Seattle, WA, 98195, USA.
Andrew S WrightDepartment of Surgery, University of Washington, 1959 NE Pacific St, Box 356410, Seattle, WA, 98195, USA.
H Alejandro RodriguezTecnológico de Monterrey, School of Medicine and Health Sciences, Monterrey, Mexico.
Rebecca G LopezDepartment of Surgery, Piedmont Atlanta Hospital, Atlanta, GA, USA.
Carlos A PellegriniDepartment of Surgery, University of Washington, 1959 NE Pacific St, Box 356410, Seattle, WA, 98195, USA.
Brant K OelschlagerDepartment of Surgery, University of Washington, 1959 NE Pacific St, Box 356410, Seattle, WA, 98195, USA. brant@uw.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundType II hiatal hernias (HH) are characterized by a portion of the gastric fundus located above the esophageal hiatus adjacent to the esophagus while the gastroesophageal junction (GEJ) remains fixed below the esophageal hiatus. This type of HH has been called the "true" paraesophageal hernia (PEH) because the fundus appears to the side of the esophagus. In our experience, Type II HHs are occasionally identified on radiographic testing, however they are rarely, if ever, confirmed intraoperatively. This led to our question: Does Type II HH exist?

methodsWe searched for evidence of type II HH in three locations: 1. Retrospective review of all first-time PEH repairs (excluding Type I HHs and re-operative cases) performed at the University of Washington Medical Center from 1994 to 2021; 2. Operative videos available on YouTube and WebSurg websites; and 3. Abstracts from the SAGES annual meetings from 2005 to 2021.

resultsWe found no evidence of Type II HH in any of our three searches. We performed 846 PEH repairs: 760 Type III, 75 Type IV, and 11 parahiatal. Upon website video review, we found only one possible type II hernia, though it too was likely a para-hiatal hernia. No video or case presentations of a type II HH were identified within SAGES annual meeting abstracts.

conclusionType II HHs do not exist as they are currently defined. Although uncommon, parahiatal hernia can easily be misinterpreted as Type II HH. We should consider changing the hiatal hernia classification system to prevent ongoing clinical confusion.

Indexed as

Hernia, HiatalLaparoscopyDiaphragmEsophagogastric JunctionEsophagusHumansHiatal herniaParaesophageal herniaParahiatal herniaType II hiatal hernia

Identifiers

PMID36261642

What OpenQuestion holds

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Registered trials

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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.