Ramírez-Oliveros BG, Río-Martínez LJ, Meixueiro-Daza LA, Rincón-Zepeda R, Rossano-García A

Language: Spanish
References: 9
Page: 42-47
PDF size: 288.54 Kb.

ABSTRACT

Introduction: recurrent hiatal hernias present a therapeutic challenge, especially in patients with a previous fundoplication. This report details the surgical treatment of a 67-year-old woman with symptomatic hiatal hernia that significantly impacted her quality of life. Case report: the patient underwent a laparoscopic hernia repair guided by intraoperative fluorescence using indocyanine green and the AirSeal^® intelligent insufflation system. During the 6-hour surgery, a Hill-type operation was performed, fixing the hepatic lobe to the diaphragm and verifying the repair in three stages with intraoperative endoscopy. A BIO-A^® mesh was used to reinforce the repair and enhance its durability. The patient experienced notable improvement, resolving dysphagia, reflux, and nocturnal discomfort. Conclusions: in the case presented, the combined use of intraoperative fluorescence, AirSeal^®, and BIO-A^® mesh contributed to the surgical precision and clinical outcomes. AirSeal^® optimized stability during insufflation and visualization, indocyanine green enabled proper recognition of structures and assessment of perfusion, while BIO-A^® mesh provided durable structural support with rapid integration. The authors recommend the use of these technologies but studies with more scientific rigor are required to evaluate their real benefits.

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