COMPLEX LAPAROSCOPIC HIATAL HERNIA REPAIR AFTER SLEEVE GASTRECTOMY

Sleeve gastrectomy is the most frequently performed surgery for obesity. While hiatal hernias are routinely repaired at the index bariatric operation, the management of late postoperative hiatal hernia involves complex clinical and surgical decision-making based on patient-specific factors. Progressive gastroesophageal reflux after sleeve gastrectomy has classically indicated revision to gastric bypass, but there are patients where due to medical comorbidities, patient preferences, or other factors, this is not an option. Here we describe the surgical management and technical considerations of a late postoperative hiatal hernia after sleeve gastrectomy which was repaired laparoscopically.