Case Report

Successful hiatal hernia repair with Nissen fundoplication by laparoscopic approach: a case report

Francis Celeste , I Made Yudi Mahardika, Wifanto Saditya Jeo

Francis Celeste
General Practitioner Siloam Hospitals Kebon Jeruk, Jakarta, Indonesia. Email:

I Made Yudi Mahardika
General Practitioner Siloam Hospitals Kebon Jeruk, Jakarta, Indonesia

Wifanto Saditya Jeo
Department of Surgery, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia ; Department of Surgery, Mochtar Riady Comprehensive Cancer Centre (MRCCC), Jakarta, Indonesia
Online First: December 01, 2020 | Cite this Article
Celeste, F., Mahardika, I., Jeo, W. 2020. Successful hiatal hernia repair with Nissen fundoplication by laparoscopic approach: a case report. Intisari Sains Medis 11(3): 1298-1301. DOI:10.15562/ism.v11i3.729

Background: Hiatus hernias represent a herniation of viscera, most commonly the stomach, into the mediastinum through the esophageal hiatus of the diaphragm.There are two main classifications, sliding hernias and paraesophageal hernias. This case study aims to evaluate the successful hiatal hernia repair with Nissen fundoplication by a laparoscopic approach.

Case Presentation: We present a case of a 60-year-old male who presented with recurrent abdominal discomfort 6 months prior to the consultation. This was accompanied by loose stools, bloating, nausea, and vomiting. An initial diagnosis of Gastroesophageal Reflux Disease (GERD) was made. Conservative treatment was initiated with limited success. Endoscopy was then performed, revealing a hiatal hernia. Surgical intervention was then chosen as a therapeutic option via a laparoscopic approach and additional Nissen fundoplication with favorable outcomes.

Conclusion: Symptomatic paraesophageal hernias are indicated for surgical repair.Paraesophageal hernias can be repaired transthoracically and transabdominal. Repairs via the transabdominal route can be performed with an open approach or laparoscopically, with the laparoscopic approach suggesting lower mortality and morbidity. Nissen fundoplication has been proven as an effective measure in GERD's control and in maintaining an intra-abdominal location of the gastroesophageal junction (GEJ).


Dean C, Etienne D, Carpentier B, Gielecki J, Tubbs RS, Loukas M. Hiatal hernias. Surg Radiol Anat. 2012;34(4):291-299.

Bresadola V, Noce L, Ventroni MG, Vianello V, Intini S, Bresadola F. Sliding hiatal hernia in patients with gastroesophageal reflux: physiopathology and surgical treatment. Minerva Chir. 2000;55(6):415-420.

Hyun JJ, Bak YT. Clinical significance of hiatal hernia. Gut Liver. 2011;5(3):267-277.

Demeester TR, Johnson LF, Kent AH. Evaluation of current operations for the prevention of gastroesophageal reflux. Ann Surg. 1974;180(4):511-525.

Donahue PE, Samelson S, Nyhus LM, Bombeck CT. The floppy Nissen fundoplication. Effective long-term control of pathologic reflux. Arch Surg. 1985;120(6):663-668.

Kahrilas PJ, Kim HC, Pandolfino JE. Approaches to the diagnosis and grading of hiatal hernia. Best Pract Res Clin Gastroenterol. 2008;22(4):601-616.

Cha RR. Find Out the Differences by Types of Hiatal Hernia!. J Neurogastroenterol Motil. 2020;26(1):4-5.

Savas N, Dagli U, Sahin B. The effect of hiatal hernia on gastroesophageal reflux disease and influence on proximal and distal esophageal reflux. Dig Dis Sci. 2008;53(9):2380-2386.

Sfara A, Dumitrascu DL. The management of hiatal hernia: an update on diagnosis and treatment. Med Pharm Rep. 2019;92(4):321-325.

Weitzendorfer M, Köhler G, Antoniou SA, Pallwein-Prettner L, Manzenreiter L, Schredl P, et al. Preoperative diagnosis of hiatal hernia: barium swallow X-ray, high-resolution manometry, or endoscopy?. Eur Surg. 2017;49(5):210-217.

Andolfi C, Jalilvand A, Plana A, Fisichella PM. Surgical Treatment of Paraesophageal Hernias: A Review. J Laparoendosc Adv Surg Tech A. 2016;26(10):778-783.

Lebenthal A, Waterford SD, Fisichella PM. Treatment and controversies in paraesophageal hernia repair. Front Surg. 2015;2:13.

Chan EG, Sarkaria IS, Luketich JD, Levy R. Laparoscopic Approach to Paraesophageal Hernia Repair. Thorac Surg Clin. 2019;29(4):395-403.

Markar SR, Mackenzie H, Huddy JR, Jamel S, Askari A, Faiz O, et al. Practice Patterns and Outcomes After Hospital Admission with Acute Para-esophageal Hernia in England. Ann Surg. 2016;264(5):854-861.

Lidor AO, Steele KE, Stem M, Fleming RM, Schweitzer MA, Marohn MR. Long-term quality of life and risk factors for recurrence after laparoscopic repair of paraesophageal hernia. JAMA Surg. 2015;150(5):424-431.

Li ZT, Ji F, Han XW, Yuan LL, Wu ZY, Xu M, et al. Role of fundoplication in treatment of patients with symptoms of hiatal hernia. Sci Rep. 2019;9(1):12544.

No Supplementary Material available for this article.
Article Views      : 57
PDF Downloads : 30