Intrathoracic stomach in hiatal hernia: the role of laparoscopic repair.

INTRODUCTION: For decades, intrathoracic stomach has been an indication for surgical repair and over time laparoscopy has become standard treatment. However, there are still many aspects in the treatment of intrathoracic stomach that are subject of debate. We performed a literature review to discuss the role of laparoscopy in intrathoracic stomach repair.

EVIDENCE ACQUISITION: We performed an extensive literature search in Pubmed, Embase and Cochrane and reviewed studies from the last 5 years. To provide a complete overview, references from the found studies are also used. All data was compiled into a review format.

EVIDENCE SYNTHESIS: Laparoscopic surgery is proven to be superior to open hiatal hernia repair in the treatment of intrathoracic stomach. The role of hernia sac excision, short esophagus, mesh reinforcement, fundoplication, complications and future perspectives are discussed in this review.

CONCLUSIONS: Laparoscopy plays a major role in the treatment of intrathoracic stomach and regarding most aspects of the treatment. All available techniques have their advantages and disadvantages, and the decision on how to repair the intrathoracic stomach, remains a tailored based decision.