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ROBOTIC REPAIR OF A GIANT DIAPHRAGMATIC HERNIA AFTER IVOR LEWIS ESOPHAGECTOMY USING A KEYHOLE MESH TECHNIQUE
Adham Elmously*, Rasa Zarnegar
Surgery, New York Presbyterian Hospital - Weill Cornell Medicine, New York, NY

Presentation
The patient is a 55-year-old man with a history of an Ivor Lewis esophagectomy for adenocarcinoma who presented acutely with a giant incarcerated diaphragmatic hernia and leukocytosis.

Technique
After the robot was docked, the abdominal contents were reduced from the mediastinum and the hiatus was re-approximated. A keyhole configuration of bio-absorbable mesh was secured to the hiatus for reinforcement. The conduit was pexied to the hiatus.The patient was discharged home on day 3 and continues to do well.

Conclusion
We present the operative approach to a giant hiatal hernia after esophagectomy, as well as demonstrate a keyhole configuration for mesh repair of the hiatus.


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