The Value of Lateral Release in Reconstruction of the Diaphragmatic Hiatus Hernia

  • End date
    Dec 31, 2026
  • participants needed
  • sponsor
    Karolinska Institutet
Updated on 19 February 2022


Patients scheduled for surgery for primary paraesophageal herniation are randomized to either conventional suturing of the crura or with the addition of lateral release.


Patient undergoing surgery for primary paraesophageal herniation, are randomized to either conventional suturing of the diaphragmatic crura only or with the addition of a diaphragmatic incision "lateral release".

The patients are examined by computed tomography before surgery and at 1 and 3 years after surgery.

SF-36 (global quality of Life instrument), GSRS (Gastrointestinal Symptoms Rating Scale), Reflux frequency issues and Watson's dysphagia score are completed before and at 3 and 6 month as well as 1 and 3 years after surgery.

Patients undergoing laparoscopic repair for paraesophageal hernia Type II-IV are eligible for inclusion in the study. Included patients will be randomized to either reconstruction of the hiatus by suturing of the crura alone or in combination with an approximately 4 cm incision of the anterior aspect of the left diaphragma "lateral release" before crural suturing. The incision will be covered with a synthetic patch after crural closure is finished. All other aspects of the surgical procedure are similar in the two groups including complete mobilization of the hernia sac before and a total fundoplication after hiatal restoration, respectively.

Condition Paraesophageal Hernia
Treatment Crura plastic
Clinical Study IdentifierNCT04179578
SponsorKarolinska Institutet
Last Modified on19 February 2022


Yes No Not Sure

Inclusion Criteria

all patients with primary hiatus hernia type II-IV who are deemed suitable for surgery

Exclusion Criteria

inability to understand the nature of the purpose of the study and/or to give informed consent
American Society of Anesthesiologists physical status-system (ASA) I-III
Achalasia or another severe esophageal motor disorder
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