ESOPHAGEAL hiatus hernia is a clinically demonstrable lesion more frequently than may be generally realized. Schatzke1 stated that by using greater than normal intra-abdominal pressure during fluoroscopic examination, hiatus hernia can be demonstrated in 70% of patients over 60 years of age. Most of these lesions are asymptomatic, and most of those with mild symptoms may respond to conservative therapy. A few, however, may be attended by symptoms and signs sufficiently grave to demand surgical intervention.
The repair of hiatus hernia may not be a simple procedure; moreover, the rate of recurrence following conventional techniques is almost prohibitive. Soutter,2 for instance, in analyzing the results of hiatus hernia repair at Massachusetts General Hospital found a recurrence rate of 14% following the transthoracic approach and a rate in excess of 40% in those patients treated by the abdominal route. One of us had the disconcerting experience of having seen
GARDNER WC, HARTZELL JB, TUTTLE WM. SIMPLIFIED TECHNIQUE FOR TREATMENT OF ESOPHAGEAL HIATUS HERNIA. AMA Arch Surg. 1952;65(4):564-569. doi:10.1001/archsurg.1952.01260020580009