Intrathoracic Stomach in Paraesophageal Hiatal Hernia; The role of Laparoscopic Collis Gastroplasty

Laparoscopy plays a major role in the treatment of intrathoracic stomach and regarding most aspects of the treatment. All available techniques have their advantages and disadvantages, and the decision on how to repair the intrathoracic stomach, remains a tailored based decision. The Collis gastroplasty as an innovative treatment for patients with hiatal hernias and shortened esophagus to address concerns of axial tension leading to hernia recurrence. Initial novel approaches to esophageal lengthening involved transthoracic passage of a stapler that would then be brought down through the hiatus and a single staple line was performed parallel to an esophageal bougie to add tubularized length to the distal esophagus. In subsequent years, as laparoscopic approaches to hiatal hernia repair became standard, the desire to avoid violation of the thoracic cavity and move toward an entirely transabdominal approach to the procedure gained favor.