Innovative Laparoscopic 'Tunnel' Approach in Managing Hiatal Hernia with gastroesophageal reflux disease: A Retrospective Study

Background Hiatal hernia (HH) is a major cause of gastroesophageal reflux disease (GERD), and laparoscopic repair combined with anti-reflux surgery is a common treatment. However, postoperative complications such as vagus nerve injury remain a concern. This study introduces a novel Laparoscopic "Tunnel" Approach aiming to minimize damage to the vagus nerve and preserve perigastric vessels. Methods A retrospective analysis was conducted on 106 patients who underwent the Laparoscopic "Tunnel" Approach for HH and GERD at the First Affiliated Hospital of Ningbo University from June 2023 to June 2024. Data collected included age, gender, BMI, DeMeester score, surgical time, and postoperative symptoms. Follow-ups were conducted at 1, 3, and 6 months postoperatively. Results The average age was 54 ± 9 years, BMI was 25.56 ± 4.32 kg/m², DeMeester score was 118.05 ± 17.71, and GERD-Q score was 13 ± 2. The average surgical time was 115 ± 15 minutes. Postoperatively, symptoms significantly improved, with an average GERD-Q score of 5 ± 1 at 6 months. At 1 month, dysphagia was observed in 14 patients, belching in 19, abdominal distension in 5, nausea in 16, and diarrhea in 8. By 6 months, only 2 patients exhibited belching, with no other symptoms persisting. No cases of vomiting or gallstones were reported. Conclusions The Laparoscopic "Tunnel" Approach effectively minimizes vagus nerve injury and preserves perigastric vessels, resulting in improved postoperative outcomes and quality of life. This method shows potential for wider application in treating HH and GERD.