PARAESOPHAGEAL HERNIAS IN THE ELDERLY - A CASE FOR LAPAROSCOPIC SURGERY

Paraesophageal hernias are uncommon conditions which appear mainly in elderly people, frequently associated with sliding hernias or gastric volvulus, Considered a high risk pathology, surgical management is pre ferred to avoid serious complications. Due to advanced age and operati ve risks, a laparoscopic approach was performed in the three patients with paraesophageal hernia. In mixed hernias, a Nissen or Toupet fundo plication and closure of the hiatal defect was carried out. In a case with gastric rotation, reduction of the herniated stomach and posterio r partial fundoplication with gastropexy was performed. No postoperati ve complications occurred and recovery was satisfactory. Laparoscopic management seems to be a good choice for elective treatment of paraeso phageal hernias in elderly patients.