Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
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
ARTICLE HIGHLIGHTS
Research background

This study was conducted to determine the accessibility obtained when the laparoscopic approach is applied to the repair of a giant hiatal hernia.

Research motivation

In patients with giant hernias, it is sometimes not possible to achieve full visibility of all areas of the sac using the laparoscopic approach.

Research objectives

The main study aim is to detect cases in which full access to all areas of the hernial sac is not possible, and so the thoracoscopic approach would be safer.

Research methods

Our study helps clarify the latter issue by providing objective data on visibility and manoeuvrability, thus informing the surgical team of the indications for the approach which is safest and produces the best results.

Research results

Information of complementary imaging tests will enable us to adopt the most suitable approach and thus optimise the results of the intervention in patients with giant hiatal hernia.

Research conclusions

From the study results obtained, 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.

Research perspectives

By determining certain parameters – the camera angle aperture, the diameter of the hernial orifice and the positioning of the trocars with respect to this orifice – we can calculate the angle of vision and the instrument working angle available during the intervention.