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3 Role of Laparoscopy in Management of Hiatal Hernias Abdul Gani Alchalabi * Abstract Aims: Evaluating the laparoscopic management of hiatal hernias with its complications and success rates. Patients and methods: The study was performed retrospectively by studying the files of 112 patients who underwent laparoscopic repair of hiatal hernias in Al Assad University Hospital between 2000 and Clinical aspects were reviewed in addition to the types and sizes of hernias. The study involved determination of type of surgery, conversion rates, intra- and postoperative complication, and period of stay in hospital. Results: A total of 112 patients were studied, ranging in age from 18 to 78 years old. Males were affected more than females (66% vs 34%). Diagnosis relied on clinical presentation, upper gastrointestinal endoscopy, and esophageal manometry. Patients were referred to surgery in all cases of paraesophageal hernias and in those cases of sliding hernia who did not respond properly to the conservative treatment. Size of the hernia was between 1 and 7 cm. Surgery involved Nissen fundoplication (76%), Toupet fundoplication (5.3%), with use of a mesh plug in recurrent and paraesophageal hernias (8.8%). Conversion rate was 2.67%. Postoperative complications involved transient dysphagia in 13.3% with spontaneous resolution, and permanent dysphagia in 1.7% of cases which was treated successfully. Stay in hospital was 1-4 days with 75% of patients being discharged on the first postoperative day. Conclusion: The study shows that laparoscopic approach to hiatal hernias has become the golden standard therapy after failure of medical therapy with high success rates and low recurrence. Key words: laparoscopic surgery, hiatal hernias, Nissen fundoplication. * Ass. Prof. Hed of department of surgery, Damascus University. 257

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