AUTOLOGOUS POSTERIOR RECTUS SHEATH AS A VASCULARIZED ONLAY FLAP: A NOVEL APPROACH TO HIATAL HERNIA REPAIR
Mary A. Varsanik*, Marie Fefferman, Yalini Vigneswaran
Surgery, University of Chicago Division of the Biological Sciences, Chicago, IL
Successful paraesophageal hernia (PEH) repairs are a challenge with high recurrence rates despite use of mesh and other techniques. Here we report the novel use of the posterior rectus sheath as a vascularized flap to repair a recurrent paraesophageal hernia.
We hypothesize the use of a large fascial patch provides dynamic tensile strength with a peritonealized surface to reconstruct the hiatal complex, while reducing risks of adhesions, strictures, and erosion with mesh. This technique can further be enhanced with diaphragmatic relaxing incisions as shown in this video. We believe this technique shows promise to enhance repairs of difficult PEH with minimal deviation from standard repairs.
Back to 2023 Abstracts