The Importance of Gastropexy in Minimally Invasive Hiatal Hernia Repair

Hiatal hernia is a complex pathology, associated with gastroesophageal reflux disease, and for which management involves complex surgical treatment. Knowing the role of gastropexy in reducing postoperative recurrences, the current study aimed to highlight the intraoperative advantages and results of this surgical technique. Our study includes 29 patients aged between 34 and 84 years. Regarding the mechanism of occurrence, two thirds of the patients presented with mixed hiatal hernias (65.52%), 31.03% with sliding hiatal hernias, and 3.45% with paraesophageal hiatal hernias. The hernia size played a decisive role in the choice of surgical procedure, whereby for large hernias (with a diameter of over 7 cm), the Nissen procedure associated with gastropexy was preferred. For hernias with a diameter of less than 7 cm, the Nissen procedure associated with hernia orifice repair was performed. For hernias between 5 and 6 cm, gastropexy was also performed. Statistical analysis revealed a close correlation between the surgical procedure and the hernia size, with p = 0.005. Out of a total of 29 patients, 18 patients had gastropexy and 11 were without gastropexy. The association of gastropexy does not increase hospitalization costs, but in the long term, it has the advantage of reducing relapse.