Laparoscopic hernia repair and fundoplication with endoscopic sleeve gastroplasty for complex hernia and GERD management in morbid obesity

摘要

Symptomatic hiatal hernia (HH) and gastroesophageal reflux disease (GERD) pose a unique medical and surgical challenge in the context of morbid obesity. On one hand, morbid obesity is a strong risk factor for GERD and HH 1,2 as a result of increased intra-abdominal pressure and inef- fective lower esophageal sphincter. 3 On the other hand, management of HH and GERD in morbid obesity is challenging because of the high risk of hernia recurrence after conventional surgical repair. 4 Therefore, an optimal solution for HH and GERD in morbid obesity is one that would provide durable hernia repair and weight loss.