Lara FJP, Zubizarreta Jimenez R, Moya Donoso FJ, Hernández Gonzalez JM, Prieto-Puga Arjona T, del Rey Moreno A, Pitarch Martinez M. Preoperative calculation of angles of vision and working area in laparoscopic surgery to treat a giant hiatal hernia. World J Gastrointest Surg 2021; 13(12): 1638-1650 [PMID: 35070069 DOI: 10.4240/wjgs.v13.i12.1638]
Corresponding Author of This Article
Francisco Javier Perez Lara, PhD, Surgeon, Surgery Service, Antequera Hospital, Avenida Poeta Muñoz Rojas s/n, Rincón de la Victoria 29730, Málaga, Spain. javinewyork@hotmail.com
Research Domain of This Article
Surgery
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Dec 27, 2021; 13(12): 1638-1650 Published online Dec 27, 2021. doi: 10.4240/wjgs.v13.i12.1638
Preoperative calculation of angles of vision and working area in laparoscopic surgery to treat a giant hiatal hernia
Francisco Javier Perez Lara, Rogelio Zubizarreta Jimenez, Francisco Javier Moya Donoso, Jose Manuel Hernández Gonzalez, Tatiana Prieto-Puga Arjona, Arturo del Rey Moreno, Maria Pitarch Martinez
Francisco Javier Perez Lara, Francisco Javier Moya Donoso, Jose Manuel Hernández Gonzalez, Tatiana Prieto-Puga Arjona, Arturo del Rey Moreno, Maria Pitarch Martinez, Surgery Service, Antequera Hospital, Rincón de la Victoria 29730, Málaga, Spain
Rogelio Zubizarreta Jimenez, DOXA Microfluidics, Rincon de la Victoria 29738, Málaga, Spain
Author contributions: Lara FJP made a substantial contribution to the concept and design; Lara FJP and Zubizarreta Jimenez R drafted the article, revised it critically for important intellectual content and approved the version to be published; Moya Donoso FJ, Hernández Gonzalez JM, Prieto-Puga Arjona T, del Rey Moreno A, Pitarch Martinez M approved the version to be published.
Institutional review board statement: The study was approved by the Antequera Hospital.
Informed consent statement: Due to the retrospective design of the study, the requirement of informed consent was waived.
Conflict-of-interest statement: Authors have no conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Francisco Javier Perez Lara, PhD, Surgeon, Surgery Service, Antequera Hospital, Avenida Poeta Muñoz Rojas s/n, Rincón de la Victoria 29730, Málaga, Spain. javinewyork@hotmail.com
Received: March 27, 2021 Peer-review started: March 27, 2021 First decision: June 14, 2021 Revised: June 21, 2021 Accepted: November 26, 2021 Article in press: November 26, 2021 Published online: December 27, 2021
Abstract
BACKGROUND
Giant hiatal hernias still pose a major challenge to digestive surgeons, and their repair is sometimes a highly complex task. This is usually performed by laparoscopy, while the role of the thoracoscopic approach has yet to be clearly defined.
AIM
To preoperatively detect patients with a giant hiatal hernia in whom it would not be safe to perform laparoscopic surgery and who, therefore, would be candidates for a thoracoscopic approach.
METHODS
In the present study, using imaging test we preoperatively simulate the field of vision of the camera and the working area (instrumental access) that can be obtained in each patient when the laparoscopic approach is used.
RESULTS
From data obtained, we can calculate the access angles that will be obtained in a preoperative computerised axial tomography coronal section, according to the location of the trocar. We also provide the formula for performing the angle calculations If the trocars are placed in loss common situations, thus enabling us to determine the visibility and manoeuvrability for any position of the trocars.
CONCLUSION
The working area determines the cases in which we can operate safely and those in which certain areas of the hernia cannot be accessed, which is when the thoracoscopic approach would be safer.
Core Tip: This study was conducted to determine the accessibility obtained when the laparoscopic approach is applied to the repair of a giant hiatal hernia. The main study aim is to detect cases in which full access to all areas of the hernial sac is not possible, and in which, therefore, the thoracoscopic approach would be safer.
