Hiatal repair in Ivor Lewis minimally invasive esophagectomy: a case report

Xu-Heng Chiang, Ke-Cheng Chen, Pei-Ming Huang, Pei-Wen Yang, Mong-Wei Lin, Jang-Ming Lee


Hiatal hernia after minimally invasive esophagectomy (MIE) is an important postoperative complication that can cause severe morbidity or even mortality among patients with esophageal cancer. Usually repair of the hiatus immediately after esophageal reconstruction is suggested to prevent such complication. However, during the Ivor Lewis MIE procedure, hiatal repair is difficult to perform due to the deep-seated location of the hiatus after the final step of esophageal reconstruction in the right chest. The current study demonstrates a method of repairing the hiatus in the Ivor Lewis MIE. This is especially useful in the resection of a massive tumor near the esophagogastric (E-G) junction, which harbors a high risk of hiatal hernia when the hiatus is left unrepaired after extensive hiatal dissection.